Healthcare Provider Details

I. General information

NPI: 1104371731
Provider Name (Legal Business Name): E R HUGHES ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46440 BENEDICT DR # 201
STERLING VA
20164-6602
US

IV. Provider business mailing address

46440 BENEDICT DR # 201
STERLING VA
20164-6602
US

V. Phone/Fax

Practice location:
  • Phone: 703-444-1152
  • Fax: 703-430-8117
Mailing address:
  • Phone: 703-444-1152
  • Fax: 703-430-8117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0401006057
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC RICHARD HUGHES
Title or Position: OWNER
Credential: DDS
Phone: 703-444-1152