Provider Demographics
NPI:1982982591
Name:DAIS, JENNIFER K (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:DAIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9242 W UNION HILLS DR STE 100-101
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-8218
Mailing Address - Country:US
Mailing Address - Phone:602-644-7004
Mailing Address - Fax:602-644-7003
Practice Address - Street 1:9242 W UNION HILLS DR BLDG D100-101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-8218
Practice Address - Country:US
Practice Address - Phone:602-644-7004
Practice Address - Fax:602-644-7003
Is Sole Proprietor?:No
Enumeration Date:2011-07-31
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTP1-0052120207LP2900X
AZ52011207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine