Provider Demographics
NPI:1295033173
Name:DAO, THIEN (DMD)
Entity Type:Individual
Prefix:
First Name:THIEN
Middle Name:
Last Name:DAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 KINGSTOWNE TOWNE CTR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5896
Mailing Address - Country:US
Mailing Address - Phone:703-719-9210
Mailing Address - Fax:703-719-6330
Practice Address - Street 1:5960 KINGSTOWNE TOWNE CTR
Practice Address - Street 2:SUITE 140
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5896
Practice Address - Country:US
Practice Address - Phone:703-719-9210
Practice Address - Fax:703-719-6330
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014128621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice