Provider Demographics
NPI:1316949753
Name:DENNIS, KATHY-ANN (MD)
Entity type:Individual
Prefix:
First Name:KATHY-ANN
Middle Name:
Last Name:DENNIS
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 1:701 COTTAGE GROVE RD STE B010
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3084
Mailing Address - Country:US
Mailing Address - Phone:860-838-7555
Mailing Address - Fax:800-392-4586
Practice Address - Street 1:701 COTTAGE GROVE RD STE B010
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3084
Practice Address - Country:US
Practice Address - Phone:860-838-7555
Practice Address - Fax:800-392-4586
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043128207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001431288Medicaid
CTI29786Medicare UPIN
CT001431288Medicaid