Provider Demographics
NPI:1396784963
Name:ANTHONY, DENNIS M (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5964 GOLF CLUB LN
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8224
Mailing Address - Country:US
Mailing Address - Phone:513-893-1100
Mailing Address - Fax:513-893-1128
Practice Address - Street 1:5964 GOLF CLUB LN
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8224
Practice Address - Country:US
Practice Address - Phone:513-893-1100
Practice Address - Fax:513-893-1128
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-081138207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2398525Medicaid
OH294482OtherAMERIGROUP PROVIDER NO
OH7584567OtherAETNA PROVIDER NUMBER
OH81138OtherHUMANA PROVIDER NUMBER
OH000000332355OtherANTHEM PROVIDER NUMBER
OH04-09744OtherUNITED HEALTH CARE PN
OH81138OtherHUMANA PROVIDER NUMBER
OHH301240Medicare PIN
OH04-09744OtherUNITED HEALTH CARE PN