Provider Demographics
NPI:1568917045
Name:T TRANG NGUYEN
Entity Type:Organization
Organization Name:T TRANG NGUYEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRANG
Authorized Official - Middle Name:THAO
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-459-0914
Mailing Address - Street 1:9500 ANNAPOLIS RD
Mailing Address - Street 2:SUITE C-6
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2060
Mailing Address - Country:US
Mailing Address - Phone:301-459-0914
Mailing Address - Fax:
Practice Address - Street 1:9500 ANNAPOLIS RD
Practice Address - Street 2:SUITE C-6
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2060
Practice Address - Country:US
Practice Address - Phone:301-459-0914
Practice Address - Fax:301-459-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD136381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty