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General NPI Number Information
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NPI Number | 1477080612
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Entity Type | Individual
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Provider Name | BENZON HAMILTON HUYNH DMD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 08/02/2018
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Provider Practice Location Address
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Address Line | 3613 CHAIN BRIDGE RD
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City | FAIRFAX
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State | VA
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Zip | 22030
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Country | US
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Telephone | 703-893-6680
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Fax |
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Provider Business Mailing Address
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Address Line | 15207 GENERAL STEVENS CT
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City | CHANTILLY
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State | VA
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Zip | 20151-1319
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Country | US
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Telephone | 571-426-8048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401416045
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401416045
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License Number State | VA
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