Provider Demographics
NPI:1659796167
Name:HUTCHISON, ALICIA LE NGUYEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:LE NGUYEN
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALICIA
Other - Middle Name:LE
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2200 OPITZ BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3321
Mailing Address - Country:US
Mailing Address - Phone:703-494-9118
Mailing Address - Fax:
Practice Address - Street 1:2200 OPITZ BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3321
Practice Address - Country:US
Practice Address - Phone:703-494-9118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014138211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics