Provider Demographics
NPI:1063441327
Name:STENNETTE, DENISE (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:STENNETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:393 E WALNUT ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:626-405-3640
Mailing Address - Fax:626-405-6768
Practice Address - Street 1:2660 E MAIN ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2893
Practice Address - Country:US
Practice Address - Phone:805-477-6070
Practice Address - Fax:805-477-6066
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77182207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG54406Medicare UPIN