Provider Demographics
NPI:1538150347
Name:DENNIS, BETH LYN (MD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:LYN
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8419 WENDELL DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-2157
Mailing Address - Country:US
Mailing Address - Phone:703-619-7062
Mailing Address - Fax:
Practice Address - Street 1:3700 FETTLER PARK
Practice Address - Street 2:DUMFRIES HEALTH CENTER
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025
Practice Address - Country:US
Practice Address - Phone:703-441-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine