Provider Demographics
NPI:1831526995
Name:NORTHERN VIRGINIA ORAL AND FACIAL SURGERY, LLC
Entity type:Organization
Organization Name:NORTHERN VIRGINIA ORAL AND FACIAL SURGERY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-449-8888
Mailing Address - Street 1:4211 FAIRFAX CORNER AVE E
Mailing Address - Street 2:SUITE 235
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-8622
Mailing Address - Country:US
Mailing Address - Phone:703-449-8888
Mailing Address - Fax:703-449-9888
Practice Address - Street 1:4211 FAIRFAX CORNER AVE E STE 235
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-8623
Practice Address - Country:US
Practice Address - Phone:703-449-8888
Practice Address - Fax:703-449-9888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN VIRGINIA ORAL AND FACIAL SURGERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413939261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery