Healthcare Provider Details

I. General information

NPI: 1962992271
Provider Name (Legal Business Name): DANIELLE DEBACKER DANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 BOONE BLVD STE 360
VIENNA VA
22182-2632
US

IV. Provider business mailing address

8230 BOONE BLVD STE 360
VIENNA VA
22182-2632
US

V. Phone/Fax

Practice location:
  • Phone: 703-748-1000
  • Fax: 703-748-1010
Mailing address:
  • Phone: 703-748-1000
  • Fax: 703-748-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number0101280330
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD600005618
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: