Lynn Akwen Sitho Andoseh, D.D.S.
Individual provider Active NPI Dentist · Washington, DC
NPI 1184862369 · NPPES record last updated Sep 24, 2014
Key facts
- NPI
- 1184862369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 15095 (MD)
- Practice address
- 1531 Maryland Ave NE
Washington, DC 20002-7604 - Phone
- (202) 470-5873
- NPI assigned
- Jan 27, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN1001371 | DC | MD | Dentist |
| 15095 | MD | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15095 | MD | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DEN1001371 | DC |
Addresses
Primary practice location
1531 Maryland Ave NE
Washington, DC 20002-7604
Mailing address
10205 Juniper Dr
Bowie, MD 20721-2721
Phone (240) 281-1983
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.