MEDICARE: QUYNH-TRANG NGUYEN, D.D.S., PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401410205	VA
2	1223G0001X	General Practice Dentistry	0401410204	VA

General Provider Information

NPI Number	:	1447317516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUYNH-TRANG NGUYEN, D.D.S., PLLC

Provider Business Mailing Address
First Line	:	6230C N KINGS HWY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2442
Country	:	US
Telephone Number	:	703-768-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	6230C N KINGS HWY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2442
Country	:	US
Telephone Number	:	703-768-9400
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	QUYNH-TRANG NGUYEN
Credential	:
Telephone Number	:	703-768-9400

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	08/22/2020

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