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NPI Code Detail

MEDICARE: STEPHANIE MARIE NUNEZ DDS, PHD

MEDICARE: STEPHANIE MARIE NUNEZ DDS, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist2901021403MI

General Provider Information

NPI Number : 1417357807
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MARIE NUNEZ DDS, PHD
Provider Business Mailing Address
First Line : 915 N QUINCY ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1907
Country : US
Telephone Number : 571-970-2006
Fax Number :
Provider Business Practice Location Address
First Line : 915 N QUINCY ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1907
Country : US
Telephone Number : 571-970-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2014
Last Update Date : 07/21/2022

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