Provider Demographics
NPI:1043595390
Name:NGUYEN & ASSOCIATES DENTAL PC
Entity Type:Organization
Organization Name:NGUYEN & ASSOCIATES DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUOC
Authorized Official - Middle Name:VO
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-310-8372
Mailing Address - Street 1:2901 TELESTAR CT
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1260
Mailing Address - Country:US
Mailing Address - Phone:703-992-0708
Mailing Address - Fax:703-992-0768
Practice Address - Street 1:2901 TELESTAR CT
Practice Address - Street 2:SUITE 120
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1260
Practice Address - Country:US
Practice Address - Phone:703-992-0708
Practice Address - Fax:703-992-0768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014108921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty