Healthcare Provider Details

I. General information

NPI: 1467503177
Provider Name (Legal Business Name): DANIEL SCOTT HINES DEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BUTTERNUT ST NW
WASHINGTON DC
20012-1925
US

IV. Provider business mailing address

405 BUTTERNUT ST NW
WASHINGTON DC
20012-1925
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-2400
  • Fax: 202-231-6163
Mailing address:
  • Phone: 202-723-2400
  • Fax: 202-231-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN5032
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDEN5032
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: