MEDICARE: DUY CHAU NGUYEN DDS 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	122300000X	Dentist

General Provider Information

NPI Number	:	1689369514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUY CHAU NGUYEN DDS PLLC

Provider Business Mailing Address
First Line	:	8160 DOUGLAS FIR DR
Second Line	:
City	:	LORTON
State	:	VA
Zip	:	22079-5657
Country	:	US
Telephone Number	:	703-688-2454
Fax Number	:

Provider Business Practice Location Address
First Line	:	9142 RICHMOND HWY STE A
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-1315
Country	:	US
Telephone Number	:	703-688-2454
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. DUY CHAU NGUYEN
Credential	:	DDS
Telephone Number	:	703-688-2454

Provider Enumeration Date	:	04/06/2023
Last Update Date	:	04/06/2023

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