Healthcare Provider Details

I. General information

NPI: 1366843484
Provider Name (Legal Business Name): JENNIFER M DENGLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E ST NW L209
WASHINGTON DC
20520-5712
US

IV. Provider business mailing address

2401 E ST NW L209
WASHINGTON DC
20520-5712
US

V. Phone/Fax

Practice location:
  • Phone: 202-679-1860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA200001780
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110011152
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: