Provider Demographics
NPI:1134447824
Name:DANG, LIEN XUAN
Entity type:Individual
Prefix:
First Name:LIEN
Middle Name:XUAN
Last Name:DANG
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LIEN
Other - Middle Name:XUANBA
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2856 LAWRENCE DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1408
Mailing Address - Country:US
Mailing Address - Phone:703-560-1569
Mailing Address - Fax:
Practice Address - Street 1:2856 LAWRENCE DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1408
Practice Address - Country:US
Practice Address - Phone:703-560-1569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205310183500000X
DCPH100000064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist