Healthcare Provider Details

I. General information

NPI: 1245854108
Provider Name (Legal Business Name): J-N VISION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 07/23/2025
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 DOLLEY MADISON BLVD SUITE 305
MC LEAN VA
22101
US

IV. Provider business mailing address

1313 DOLLEY MADISON BLVD SUITE 305
MC LEAN VA
22101
US

V. Phone/Fax

Practice location:
  • Phone: 703-988-7744
  • Fax: 703-997-3008
Mailing address:
  • Phone: 703-988-7744
  • Fax: 703-997-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DUC Y. NGUYEN
Title or Position: OWNER
Credential: O.D.
Phone: 703-997-3008