Organization
WALTER REED NATIONAL MILITARY MEDICAL CNTR
Active
Parent organization
WALTER REED NATIONAL MILITARY MEDICAL CNTR
Other names
PENTAGON TRI-SVC DENTAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALTER REED NATIONAL MILITARY MEDICAL CNTR
Authorized official
MARCIA DICKSON (FINANCIAL MGMT ANALYST)
(301) 295-6300
Entity
Organization
Contact information
Practice address
THE PENTAGON, CORRIDOR 8, WASHINGTON, DC 20310-0001
(703) 692-8700
Mailing address
8901 WISCONSIN AVE, PSC BOX 509 CODE 6300, BETHESDA, MD 20889-5600
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639130222
PARENT FACILITY NPI EFFECTIVE 1 SEP 2011
—
Enumeration date
06/08/2007
Last updated
05/21/2025
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