Provider Demographics
NPI:1699776773
Name:DORANS, DENNIS M (OD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:M
Last Name:DORANS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01069-1215
Mailing Address - Country:US
Mailing Address - Phone:413-283-3511
Mailing Address - Fax:413-283-5396
Practice Address - Street 1:1504 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1215
Practice Address - Country:US
Practice Address - Phone:413-283-3511
Practice Address - Fax:413-283-5396
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3344152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2616968OtherAETNA
W16079OtherBCBS
000000020721OtherHEALTHNET
2117490OtherFIRST HEALTH
350274OtherCMHC
4870600-002OtherCIGNA
982182OtherNETWORK HEALTH
MA1270OtherEYEMED
MA0353736Medicaid
334400OtherCONNECTICARE
152675OtherHARVARD PILGRIM
39707OtherDAVIS VISION
152675OtherHARVARD PILGRIM
D0410858Medicare ID - Type Unspecified