Provider Demographics
NPI:1922855352
Name:HUGHES, KENISE S (RDH)
Entity type:Individual
Prefix:
First Name:KENISE
Middle Name:S
Last Name:HUGHES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11522 TIMBERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-2935
Mailing Address - Country:US
Mailing Address - Phone:202-460-8174
Mailing Address - Fax:
Practice Address - Street 1:3301 NEW MEXICO AVE NW STE 323
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3624
Practice Address - Country:US
Practice Address - Phone:202-686-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHYG1001098124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist