Provider Demographics
NPI:1982796918
Name:DAPPEN, ALAN W
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:W
Last Name:DAPPEN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ALAN
Other - Middle Name:
Other - Last Name:DAPPEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:360 MAPLE AVE W
Mailing Address - Street 2:SUITE E
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5614
Mailing Address - Country:US
Mailing Address - Phone:703-938-4604
Mailing Address - Fax:703-938-4618
Practice Address - Street 1:360 MAPLE AVE W
Practice Address - Street 2:SUITE E
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5614
Practice Address - Country:US
Practice Address - Phone:703-938-4604
Practice Address - Fax:703-938-4618
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF09900Medicare UPIN