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NPI Code Detail

MEDICARE: MARK JUSTIN NUNES

MEDICARE: MARK JUSTIN NUNES
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
11223P0221XPediatric DentistryDEN2000241DC
21223P0221XPediatric Dentistry0401419812VA
31223P0221XPediatric Dentistry18115MD

General Provider Information

NPI Number : 1881289213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK JUSTIN NUNES
Provider Business Mailing Address
First Line : 440 PENN ST NE APT 1212
Second Line :
City : WASHINGTON
State : DC
Zip : 20002-8394
Country : US
Telephone Number : 515-745-5368
Fax Number :
Provider Business Practice Location Address
First Line : 111 MICHIGAN AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-2916
Country : US
Telephone Number : 515-745-5368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2021
Last Update Date : 01/15/2026

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