Provider Demographics
NPI:1518206424
Name:DENTONI-LASOFSKY, DENNIS RICHARD (RN, NP-C, MSN)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:RICHARD
Last Name:DENTONI-LASOFSKY
Suffix:
Gender:M
Credentials:RN, NP-C, MSN
Other - Prefix:
Other - First Name:DENNIS
Other - Middle Name:RICHARD
Other - Last Name:DENTONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1916 KIRKHAM ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3322
Mailing Address - Country:US
Mailing Address - Phone:415-583-5845
Mailing Address - Fax:
Practice Address - Street 1:1916 KIRKHAM ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-3322
Practice Address - Country:US
Practice Address - Phone:415-583-5845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201241579RN163W00000X
NY664630163W00000X
CA832860163W00000X
CA95015130363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse