Healthcare Provider Details

I. General information

NPI: 1891813671
Provider Name (Legal Business Name): HERBERT M HUGHES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7906 ANDRUS RD # 19
ALEXANDRIA VA
22306-3168
US

IV. Provider business mailing address

7906 ANDRUS RD # 19
ALEXANDRIA VA
22306-3168
US

V. Phone/Fax

Practice location:
  • Phone: 703-360-8660
  • Fax: 703-360-5051
Mailing address:
  • Phone: 703-360-8660
  • Fax: 703-360-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number401006384
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: