Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

KENNEDI WICKHAM
NPI 1225955545
Dermatology in Glenn Dale, MD

Active since June 30, 2026
12200 ANNAPOLIS RD STE 315, GLENN DALE, MD 20769(301) 249-0970 Get Directions Write a Review

NPPES record added: June 30, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kennedi Wickham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEDI WICKHAM (NPI 1225955545) is an individual dermatology provider in Glenn Dale, Maryland, licensed in Maryland (C0010599) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1225955545
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameKENNEDI WICKHAM
Location Address12200 ANNAPOLIS RD STE 315Glenn Dale, MD 20769-9182
Mailing Address13917 Rockingham RdGermantown, MD 20874-2230
Sole ProprietorNo
Enumeration DateJune 30, 2026
NPPES CertifiedJune 30, 2026
NPI 1225955545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in MD · C0010599
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

12200 ANNAPOLIS RD STE 315, Glenn Dale, MD 20769

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
12200 ANNAPOLIS RD STE 315
GLENN DALE, MD 20769

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennedi Wickham's NPI number?

The NPI number for Kennedi Wickham is 1225955545. It was assigned to this individual provider in the NPPES registry on June 30, 2026.

Where is Kennedi Wickham located?

Kennedi Wickham practices at 12200 Annapolis Rd Ste 315, Glenn Dale, MD 20769. The listed phone number is (301) 249-0970.

What is Kennedi Wickham's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Kennedi Wickham was last updated on June 30, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.