Healthcare Provider Details

I. General information

NPI: 1649553819
Provider Name (Legal Business Name): VIVIAN V CLICK DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIVIAN V KAUFMAN DDS

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW SUITE 305
WASHINGTON DC
20006-1003
US

IV. Provider business mailing address

2021 K ST NW SUITE 305
WASHINGTON DC
20006-1003
US

V. Phone/Fax

Practice location:
  • Phone: 202-835-3636
  • Fax:
Mailing address:
  • Phone: 202-835-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number30-023521
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2515
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDEN1001624
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: