Provider Demographics
NPI:1720154495
Name:TIEN, NIVEN T (DDS,MD)
Entity type:Individual
Prefix:DR
First Name:NIVEN
Middle Name:T
Last Name:TIEN
Suffix:
Gender:M
Credentials:DDS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14955 SHADY GROVE ROAD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20850-8720
Mailing Address - Country:US
Mailing Address - Phone:301-340-0101
Mailing Address - Fax:
Practice Address - Street 1:4301 50TH ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4396
Practice Address - Country:US
Practice Address - Phone:202-360-4032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14962204E00000X
DCMD0445282086S0122X
MDD00753152086S0122X
DCDEN10012231223S0112X
TXP20722082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck