DENNIS BUENAVENTURA CUSTODIO INDEPENDENT DUTY HM
NPI 1013264423
Military Health Care Provider - Independent Duty Corpsman in Groton, CT

Q: What is Dennis Custodio's NPI number?

The NPI number for Dennis Custodio is 1013264423. It was assigned to this individual provider in the NPPES registry on August 6, 2012.

Q: What is Dennis Custodio's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Dennis Custodio was last updated on August 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 06, 2012

69 TROUT AVE, NAVAL UNDERSEA MEDICAL INSTITUTE, GROTON, CT 06349(253) 905-8239 Get Directions Write a Review

NPPES record last updated: August 6, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dennis Buenaventura Custodio Independent Duty Hm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DENNIS BUENAVENTURA CUSTODIO INDEPENDENT DUTY HM (NPI 1013264423) is an individual independent duty corpsman provider in Groton, Connecticut and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1013264423

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameDENNIS BUENAVENTURA CUSTODIOCredential: INDEPENDENT DUTY HM

Location Address69 TROUT AVE, NAVAL UNDERSEA MEDICAL INSTITUTEGroton, CT 06349

Mailing Address6910 227th Street Ct ESpanaway, WA 98387-5841 · (253) 905-8239

Phone(253) 905-8239

Sole ProprietorYes

Enumeration DateAugust 6, 2012

✔ NPI 1013264423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

69 TROUT AVE, Groton, CT 06349

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dennis Custodio's NPI number?

The NPI number for Dennis Custodio is 1013264423. It was assigned to this individual provider in the NPPES registry on August 6, 2012.

Where is Dennis Custodio located?

Dennis Custodio practices at 69 Trout Ave Naval Undersea Medical Institute, Groton, CT 06349. The listed phone number is (253) 905-8239.

What is Dennis Custodio's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Dennis Custodio was last updated on August 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.