Provider Demographics
NPI:1225349574
Name:VONDERLINDEN, DANNIELLE (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANNIELLE
Middle Name:
Last Name:VONDERLINDEN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9010 LORTON STATION BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4792
Mailing Address - Country:US
Mailing Address - Phone:571-418-8670
Mailing Address - Fax:571-418-8671
Practice Address - Street 1:9010 LORTON STATION BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4792
Practice Address - Country:US
Practice Address - Phone:571-418-8670
Practice Address - Fax:571-418-8671
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301037213ES0103X
FLPO3420213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7404180001Medicare NSC