Provider Demographics
NPI:1649871906
Name:DENNES, MARGARET JOLENE
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:JOLENE
Last Name:DENNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SOUTHWICK DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2625
Mailing Address - Country:US
Mailing Address - Phone:330-212-0229
Mailing Address - Fax:
Practice Address - Street 1:26 SOUTHWICK DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2625
Practice Address - Country:US
Practice Address - Phone:330-212-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1826162374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0134339Medicaid