MEDICARE: DR. PHILIP J VARGAS DDS

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	30944	CA

General Provider Information

NPI Number	:	1942306402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP J VARGAS DDS

Provider Business Mailing Address
First Line	:	1441 RHODE ISLAND AVENUE, NW
Second Line	:	#306
City	:	WASHINGTON
State	:	DC
Zip	:	20005-5445
Country	:	US
Telephone Number	:	202-234-0390
Fax Number	:	202-234-0390

Provider Business Practice Location Address
First Line	:	1016 BUCHANAN ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20374-5020
Country	:	US
Telephone Number	:	202-433-0813
Fax Number	:	202-433-4827

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/08/2007

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