MEDICARE: DR. ANDREW HINKLE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401413218	VA
2	1223G0001X	General Practice Dentistry	0401413218	VA

General Provider Information

NPI Number	:	1174818298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW HINKLE DDS

Provider Business Mailing Address
First Line	:	6711 WHITTIER AVE
Second Line	:	SUITE 103
City	:	MC LEAN
State	:	VA
Zip	:	22101-4538
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6711 WHITTIER AVE
Second Line	:	SUITE 103
City	:	MC LEAN
State	:	VA
Zip	:	22101-4538
Country	:	US
Telephone Number	:	703-356-4034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	06/16/2011

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