Individual provider Active NPI

Lindsay Elizabeth Tymon, DMD

  • Dentist
  • MC Lean, VA
National Provider Identifier
1104106566
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413245 Issued in VA
Practice address
6707 Old Dominion Dr
Ste 240
MC Lean, VA 22101-4504
Phone
(703) 734-2750
NPI assigned
Aug 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413245 VA Primary

Addresses

Primary practice location

6707 Old Dominion Dr
Ste 240
MC Lean, VA 22101-4504

Mailing address

4428 16TH St N
Arlington, VA 22207-2130
Phone (717) 799-4312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401413245VAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1104106566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 16TH ST N",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222072130",
            "telephone_number": "717-799-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 OLD DOMINION DR",
            "address_2": "STE 240",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014504",
            "telephone_number": "703-734-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYMON",
        "first_name": "LINDSAY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.