Organization Active NPI

Thien Long, LLC

  • Internal Medicine Physician
  • Gaithersburg, MD
National Provider Identifier
1174801609
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0063163 Issued in MD
Legal business name
THIEN LONG, LLC
Practice address
4 Professional Dr Ste 133
Gaithersburg, MD 20879-3426
Phone
(301) 974-9625
NPI assigned
Aug 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen NguyenNPI 1265596050
Title
Physician
Phone
(301) 569-6176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D0063163 MD Primary

Addresses

Primary practice location

4 Professional Dr Ste 133
Gaithersburg, MD 20879-3426

Mailing address

4 Professional Dr
Suite 133
Gaithersburg, MD 20879-3407
Phone (301) 974-9625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000170 DC Part B Supplier - Clinic/Group Practice 5092977876 Receives reassigned benefits from 1 practitioner
Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1174801609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PROFESSIONAL DR",
            "address_2": "SUITE 133",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793407",
            "telephone_number": "301-974-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PROFESSIONAL DR STE 133",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793426",
            "telephone_number": "301-974-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIEN LONG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-569-6176"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0063163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.