Healthcare Provider Details

I. General information

NPI: 1710116181
Provider Name (Legal Business Name): ANN M MINEHART D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3818 DAVIS PL NW APT 101
WASHINGTON DC
20007-1355
US

IV. Provider business mailing address

1712 I ST NW STE 800
WASHINGTON DC
20006-3740
US

V. Phone/Fax

Practice location:
  • Phone: 772-285-5484
  • Fax:
Mailing address:
  • Phone: 202-872-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN3854
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: