Provider Demographics
NPI:1508040734
Name:NGUYEN, JENNIFER CASPERS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CASPERS
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 1:5405 TUCKERMAN LN
Mailing Address - Street 2:APT 418
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-7301
Mailing Address - Country:US
Mailing Address - Phone:717-817-4805
Mailing Address - Fax:
Practice Address - Street 1:5701 CENTRE SQUARE DR
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1916
Practice Address - Country:US
Practice Address - Phone:703-968-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist