Provider Demographics
NPI:1215597216
Name:NGUYEN, KHOA DINH DANG (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:KHOA
Middle Name:DINH DANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 NOVA CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5902
Mailing Address - Country:US
Mailing Address - Phone:240-498-0214
Mailing Address - Fax:
Practice Address - Street 1:303 NOVA CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5902
Practice Address - Country:US
Practice Address - Phone:240-498-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist