Provider Demographics
NPI:1891811147
Name:DANG, SON HUYNH (DC)
Entity Type:Individual
Prefix:
First Name:SON
Middle Name:HUYNH
Last Name:DANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1049
Mailing Address - Country:US
Mailing Address - Phone:703-933-2883
Mailing Address - Fax:703-933-2884
Practice Address - Street 1:5140 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1049
Practice Address - Country:US
Practice Address - Phone:703-933-2883
Practice Address - Fax:703-933-2884
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA623779OtherNCPPO
VAH8870001OtherBCBS
VA142562OtherANTHEM
VA142562OtherANTHEM