Vienna Dermatology, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

0101244058 Issued in VA

Legal business name

VIENNA DERMATOLOGY, LLC

Practice address

410 Maple Ave W Ste 3
Vienna, VA 22180-4224

Phone

(703) 281-3626

Fax

(703) 281-3615

NPI assigned

Sep 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mai Hoang Nguyen, M.D.NPI 1275612319

Title

Physician/Owner

Phone

(703) 281-3626

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

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

• Mai Hoang Nguyen, MD

  • Dermatology Physician
  • Vienna, VA
  • NPI 1275612319

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411171200000",
    "number": "1689076747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MAPLE AVE W STE 3",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804224",
            "telephone_number": "703-281-3626",
            "fax_number": "703-281-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MAPLE AVE W STE 3",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804224",
            "telephone_number": "703-281-3626",
            "fax_number": "703-281-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIENNA DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-20",
        "last_updated": "2014-09-20",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MAI",
        "authorized_official_middle_name": "HOANG",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "703-281-3626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "VA",
            "license": "0101244058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A948510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Alexandra Vera, LCSW
• Vertical Wellness Spine and Health LLC
• Vienna Chiropractic Associates PC
• Vienna Clinic, PLLC
• Vienna Dental Care, P.C.
• Vienna Drug Center Inc
• Vienna Internal Medicine Associates PC
• Vienna Medical Group PLLC
• Vienna Neurological Institute PLLC
• Vienna Optical Co., Inc

• Clinic/Center in Vienna, VA
• Providers in Vienna, VA by specialty
• Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2014; 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.