Healthcare Provider Details

I. General information

NPI: 1558740670
Provider Name (Legal Business Name): LAMSON DANG NGUYEN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6404 SEVEN CORNERS PLACE STE K
FALLS CHURCH VA
22044-2034
US

IV. Provider business mailing address

6404 SEVEN CORNERS PLACE STE K
FALLS CHURCH VA
22044-2034
US

V. Phone/Fax

Practice location:
  • Phone: 703-536-8864
  • Fax: 703-536-4290
Mailing address:
  • Phone: 703-536-8864
  • Fax: 703-536-4290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116027849
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: