Healthcare Provider Details

I. General information

NPI: 1164483517
Provider Name (Legal Business Name): TRANG T. VO-NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25055 RIDING PLZ SUITE 140
CHANTILLY VA
20152-5917
US

IV. Provider business mailing address

25055 RIDING PLZ SUITE 140
CHANTILLY VA
20152-5917
US

V. Phone/Fax

Practice location:
  • Phone: 703-327-8200
  • Fax: 703-327-7800
Mailing address:
  • Phone: 703-327-8200
  • Fax: 703-327-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number0101246352
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: