Provider Demographics
NPI:1093387284
Name:NGUYEN, QUYNH HUONG THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:QUYNH HUONG
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1600
Mailing Address - Country:US
Mailing Address - Phone:703-670-4838
Mailing Address - Fax:
Practice Address - Street 1:16150 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1600
Practice Address - Country:US
Practice Address - Phone:703-670-4838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014175221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice