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NPI Code Detail

MEDICARE: DR. KYLE CAMERON DENNIS PH.D.

MEDICARE: DR. KYLE CAMERON DENNIS PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologistIL

General Provider Information

NPI Number : 1689657629
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE CAMERON DENNIS PH.D.
Provider Business Mailing Address
First Line : 12836 SILVIA LOOP
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22192-5093
Country : US
Telephone Number : 202-745-8379
Fax Number : 202-745-8579
Provider Business Practice Location Address
First Line : 50 IRVING ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20422-0001
Country : US
Telephone Number : 202-745-8379
Fax Number : 202-745-8579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 07/08/2007

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