MEDICARE: LIEN XUAN DANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202205310	VA
2	183500000X	Pharmacist	PH100000064	DC

General Provider Information

NPI Number	:	1134447824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIEN XUAN DANG

Provider Business Mailing Address
First Line	:	2856 LAWRENCE DR
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-1408
Country	:	US
Telephone Number	:	703-560-1569
Fax Number	:

Provider Business Practice Location Address
First Line	:	2856 LAWRENCE DR
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-1408
Country	:	US
Telephone Number	:	703-560-1569
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2010
Last Update Date	:	05/05/2010

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Directions to “ LIEN XUAN DANG ” Practice Location

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