Wynkoop, Todd E

Wynkoop, Todd E is an sole proprietor health care provider with primary practice located at 12510 Lake Ridge Dr Ste C , Woodbridge VA 22192-7501. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Wynkoop, Todd E can be contacted via phone (703) 494-8624.

Contact Information

Primary practice address
12510 Lake Ridge Dr Ste C Woodbridge VA 22192-7501
Fax: (703) 497-1258
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 0401007464 Virginia

Profile Details

NPI number 1265446561
LBN Legal business name Wynkoop, Todd E
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2006
Last updated Jul 15th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265446561 NPPES
Virginia Other 0401007464 BLUE CROSS BLUE SHIELD
Virginia Other 872859 BLUE CROSS BLUE SHIELD

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