Provider Demographics
NPI:1346327269
Name:DAO, QUYEN (DDS)
Entity Type:Individual
Prefix:
First Name:QUYEN
Middle Name:
Last Name:DAO
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 1:3000 ANNANDALE RD # 106
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2730
Mailing Address - Country:US
Mailing Address - Phone:703-204-1771
Mailing Address - Fax:703-204-4797
Practice Address - Street 1:3000 ANNANDALE RD # 106
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2730
Practice Address - Country:US
Practice Address - Phone:703-204-1771
Practice Address - Fax:703-204-4797
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410266122300000X
MD13013122300000X
DCDEN1000165122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA04014688Medicaid