Healthcare Provider Details

I. General information

NPI: 1326461815
Provider Name (Legal Business Name): DAWN DANDY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 02/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MASSACHUSETTS AVE. SE, BLDG. 8 STD CLINIC
WASHINGTON DC
20003
US

IV. Provider business mailing address

899 NORTH CAPITOL STREET NE ROOM 4000 DISTRICT OF COLUMBIA DEPT. OF HEALTH, STD/TB DIV.
DISTRICT OF COLUMBIA DC
20002
US

V. Phone/Fax

Practice location:
  • Phone: 202-698-4750
  • Fax:
Mailing address:
  • Phone: 202-671-4843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberDCPA30114
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: