Provider Demographics
NPI:1952450132
Name:HO, TIEN T (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIEN
Middle Name:T
Last Name:HO
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 1:11470 FOXCLOVE RD
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1147
Mailing Address - Country:US
Mailing Address - Phone:703-716-1219
Mailing Address - Fax:
Practice Address - Street 1:4330 EVERGREEN LN
Practice Address - Street 2:SUITE F-1
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3238
Practice Address - Country:US
Practice Address - Phone:703-941-5063
Practice Address - Fax:703-941-8955
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA88371223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics