Provider Demographics
NPI:1649553819
Name:CLICK, VIVIAN V (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:V
Last Name:CLICK
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:VIVIAN
Other - Middle Name:V
Other - Last Name:KAUFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2021 K ST NW
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1003
Mailing Address - Country:US
Mailing Address - Phone:202-835-3636
Mailing Address - Fax:
Practice Address - Street 1:2021 K ST NW
Practice Address - Street 2:SUITE 305
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1003
Practice Address - Country:US
Practice Address - Phone:202-835-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0235211223E0200X
HI25151223E0200X
DCDEN10016241223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics