Provider Demographics
NPI:1396967436
Name:NGUYEN, BICH-DAO (DDS)
Entity type:Individual
Prefix:DR
First Name:BICH-DAO
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DAO
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8998 LORTON STATION BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4789
Mailing Address - Country:US
Mailing Address - Phone:703-339-3898
Mailing Address - Fax:703-261-7342
Practice Address - Street 1:8998 LORTON STATION BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4789
Practice Address - Country:US
Practice Address - Phone:703-339-3898
Practice Address - Fax:703-261-7342
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014108681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice