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General NPI Number Information
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NPI Number | 1891365938
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Entity Type | Individual
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Provider Name | KIMMIE HUYNH NGUYEN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 1201 I ST NW STE 110A
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City | WASHINGTON
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State | DC
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Zip | 20005-6004
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Country | US
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Telephone | 202-315-0953
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Fax |
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Provider Business Mailing Address
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Address Line | 7543 HOOES RD
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City | SPRINGFIELD
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State | VA
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Zip | 22150-4425
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Country | US
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Telephone | 703-472-8724
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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 | 0401417503
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License Number State | VA
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