=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386892800
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. CATHERINE P. NGUYEN P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2008
-----------------------------------------------------
Last Update Date | 09/09/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5142 LEESBURG PIKE
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-998-5559
-----------------------------------------------------
Fax | 703-998-5955
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5142 LEESBURG PIKE
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-998-5559
-----------------------------------------------------
Fax | 703-998-5955
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. CATHERINE P. NGUYEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-998-5559
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 0401411678
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------