Provider Demographics
NPI:1265280382
Name:NGHIEM, ALYSSA T (DMD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:T
Last Name:NGHIEM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SAINT RICHARDS CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-3670
Mailing Address - Country:US
Mailing Address - Phone:540-255-3979
Mailing Address - Fax:
Practice Address - Street 1:3565 LANGSTON BLVD # S3B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-3756
Practice Address - Country:US
Practice Address - Phone:571-447-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program