Healthcare Provider Details

I. General information

NPI: 1982532396
Provider Name (Legal Business Name): DELLWYNN OXENDINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 GANNET LN
MIDLOTHIAN VA
23112-4959
US

IV. Provider business mailing address

3237 GANNET LN
MIDLOTHIAN VA
23112-4959
US

V. Phone/Fax

Practice location:
  • Phone: 804-691-2242
  • Fax: 804-691-2242
Mailing address:
  • Phone: 804-691-2242
  • Fax: 804-691-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019020255
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: