MEDICARE: DR. VICTORIA LEIGH CASTENS HYNES DMD

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
1	1223G0001X	General Practice Dentistry	16638	MD
2	1223G0001X	General Practice Dentistry	DEN1002003	DC

General Provider Information

NPI Number	:	1710466727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA LEIGH CASTENS HYNES DMD

Provider Business Mailing Address
First Line	:	425 MASSACHUSETTS AVE NW APT 1019
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-7632
Country	:	US
Telephone Number	:	609-760-0173
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 S CAPITOL ST SW STE B
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-3529
Country	:	US
Telephone Number	:	202-621-8446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2018
Last Update Date	:	08/20/2020

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