Provider Demographics
NPI:1407657455
Name:NORTHERN VIRGINIA ORAL AND FACIAL SURGERY, LLC
Entity type:Organization
Organization Name:NORTHERN VIRGINIA ORAL AND FACIAL SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUY
Authorized Official - Middle Name:CHI
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-449-8888
Mailing Address - Street 1:400 HOLIDAY CT STE 203
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-4349
Mailing Address - Country:US
Mailing Address - Phone:540-347-0274
Mailing Address - Fax:
Practice Address - Street 1:400 HOLIDAY CT STE 203
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-4349
Practice Address - Country:US
Practice Address - Phone:540-347-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN VIRGINIA ORAL AND FACIAL SURGERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty