Provider Demographics
NPI:1679690945
Name:KAY, VICTORIA I
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:I
Last Name:KAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10753 B AMBASSADOR DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109
Mailing Address - Country:US
Mailing Address - Phone:703-369-7173
Mailing Address - Fax:703-369-3616
Practice Address - Street 1:10753 B AMBASSADOR DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109
Practice Address - Country:US
Practice Address - Phone:703-369-7173
Practice Address - Fax:703-369-3616
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA40165441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice