Healthcare Provider Details

I. General information

NPI: 1932304029
Provider Name (Legal Business Name): TU-QUYNH NGUYEN ERICKSON D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 18TH ST NW STE 203
WASHINGTON DC
20036-6501
US

IV. Provider business mailing address

712 N JEFFERSON ST
ARLINGTON VA
22205-1128
US

V. Phone/Fax

Practice location:
  • Phone: 202-716-7626
  • Fax:
Mailing address:
  • Phone: 703-899-4639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number052973
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: