Provider Demographics
NPI:1164175253
Name:VANDERLINDEN, NATHAN JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:JOHN
Last Name:VANDERLINDEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 18TH ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-3524
Mailing Address - Country:US
Mailing Address - Phone:202-293-5805
Mailing Address - Fax:
Practice Address - Street 1:818 18TH ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3524
Practice Address - Country:US
Practice Address - Phone:202-293-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN2000015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist