Provider Demographics
NPI:1194774117
Name:DOBRITT, DENNIS WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:WILLIAM
Last Name:DOBRITT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5555 GLENWOOD HILLS PKWY SE STE 2
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49512-2091
Mailing Address - Country:US
Mailing Address - Phone:616-940-2662
Mailing Address - Fax:616-940-1965
Practice Address - Street 1:32255 NORTHWESTERN HWY STE 165
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1505
Practice Address - Country:US
Practice Address - Phone:248-735-8272
Practice Address - Fax:248-735-7276
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101008294208VP0014X, 207LP2900X, 208100000X, 2081P2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
116691OtherMERCY PLANS
B46714OtherHEALTH ALLIANCE PLAN
050083295OtherRAILROAD MEDICARE
4619631OtherAETNA
C7806OtherMCARE
10045580005OtherWELLNESS PLAN
MI4739191-11Medicaid
7577761OtherCIGNA
MI4739208-11Medicaid
MI555633792OtherBLUE CROSS BLUE SHIELD
B467140013OtherSELECT CARE
B467140013OtherSELECT CARE
B46714Medicare UPIN