Healthcare Provider Details
I. General information
NPI: 1528428380
Provider Name (Legal Business Name): JESSICA LYNN CINDASS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/07/2016
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US
IV. Provider business mailing address
3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US
V. Phone/Fax
- Phone: 571-231-3224
- Fax:
- Phone: 210-916-0439
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 0101263245 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 0101263245 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: