Healthcare Provider Details

I. General information

NPI: 1245173624
Provider Name (Legal Business Name): RENJINMING DAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LINCOLN CIR
MC LEAN VA
22102-5842
US

IV. Provider business mailing address

301 MAPLE AVE W STE 210
VIENNA VA
22180-4301
US

V. Phone/Fax

Practice location:
  • Phone: 972-689-0854
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121001261
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: