Provider Demographics
NPI:1811761810
Name:CASIDO, DENNIS
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:CASIDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 N HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-4529
Mailing Address - Country:US
Mailing Address - Phone:916-730-4337
Mailing Address - Fax:
Practice Address - Street 1:6155 N HAVEN DR
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-4529
Practice Address - Country:US
Practice Address - Phone:916-730-4337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)