=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801035274
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT H DENNIS, II, M.D., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2009
-----------------------------------------------------
Last Update Date | 02/09/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1140 VARNUM ST NE SUITE 103
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20017-2151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-832-8250
-----------------------------------------------------
Fax | 202-832-8252
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1140 VARNUM ST NE SUITE 103
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20017-2151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-832-8250
-----------------------------------------------------
Fax | 202-832-8252
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ROBERT H. DENNIS II
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 202-832-8250
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | MD12264
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------