Provider Demographics
NPI:1275700544
Name:DAO T NGUYEN DDS PC
Entity Type:Organization
Organization Name:DAO T NGUYEN DDS PC
Other - Org Name:LORTON STATION DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAO
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-339-3898
Mailing Address - Street 1:8998 LORTON STATION BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4789
Mailing Address - Country:US
Mailing Address - Phone:703-339-3898
Mailing Address - Fax:703-261-7342
Practice Address - Street 1:8998 LORTON STATION BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4789
Practice Address - Country:US
Practice Address - Phone:703-339-3898
Practice Address - Fax:703-261-7342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014108681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty