Healthcare Provider Details

I. General information

NPI: 1962117200
Provider Name (Legal Business Name): TOAN DUONG DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 TIMBERWOOD BLVD
CHARLOTTESVILLE VA
22911-7593
US

IV. Provider business mailing address

1752 TIMBERWOOD BLVD
CHARLOTTESVILLE VA
22911-7593
US

V. Phone/Fax

Practice location:
  • Phone: 434-974-6492
  • Fax:
Mailing address:
  • Phone: 434-974-6492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: TOAN Q DUONG
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 703-901-0570