Healthcare Provider Details

I. General information

NPI: 1720403280
Provider Name (Legal Business Name): JANICE DE VITO MUNIR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANICE DE VITO DMD

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 PENNSYLVANIA AVE SE STE 220
WASHINGTON DC
20003-4338
US

IV. Provider business mailing address

925 H ST NW APT 506
WASHINGTON DC
20001
US

V. Phone/Fax

Practice location:
  • Phone: 202-849-3292
  • Fax:
Mailing address:
  • Phone: 516-640-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number0401414321
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401414321
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number17891
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN1002089
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: