Healthcare Provider Details

I. General information

NPI: 1083682801
Provider Name (Legal Business Name): SHARI LYNN GENTRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 N ST SE
WASHINGTON DC
20374-5162
US

IV. Provider business mailing address

6808 OLD CHESTERBROOK RD
MC LEAN VA
22101-4406
US

V. Phone/Fax

Practice location:
  • Phone: 202-433-3758
  • Fax:
Mailing address:
  • Phone: 910-546-9266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101238569
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: