Provider Demographics
NPI:1720392871
Name:LU, HUNG QUOC CHAU (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:HUNG QUOC
Middle Name:CHAU
Last Name:LU
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:DR
Other - First Name:QUOC
Other - Middle Name:CHAU
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MSD
Mailing Address - Street 1:9504 CLAYCHIN CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4187
Mailing Address - Country:US
Mailing Address - Phone:703-626-0333
Mailing Address - Fax:
Practice Address - Street 1:6479 OLD BEULAH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315
Practice Address - Country:US
Practice Address - Phone:703-822-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-31
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014127851223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics