Provider Demographics
NPI:1316235948
Name:DAVINCI PLASTIC SURGERY
Entity type:Organization
Organization Name:DAVINCI PLASTIC SURGERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-966-9590
Mailing Address - Street 1:3301 NEW MEXICO AVE NW STE 236
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3610
Mailing Address - Country:US
Mailing Address - Phone:202-966-9590
Mailing Address - Fax:
Practice Address - Street 1:3301 NEW MEXICO AVE NW STE 236
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3610
Practice Address - Country:US
Practice Address - Phone:202-966-9590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVINCI PLASTIC SURGERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty