Provider Demographics
NPI:1144112830
Name:WOODBURN DENTAL CARE
Entity type:Organization
Organization Name:WOODBURN DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIEP
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-362-3742
Mailing Address - Street 1:7304 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5820
Mailing Address - Country:US
Mailing Address - Phone:703-362-3742
Mailing Address - Fax:
Practice Address - Street 1:3299 WOODBURN RD STE 120
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7311
Practice Address - Country:US
Practice Address - Phone:703-362-3742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty