Provider Demographics
NPI:1548303241
Name:NGUYEN, PHUONG NGOC LAPHONSE (DDS, MS)
Entity type:Individual
Prefix:
First Name:PHUONG
Middle Name:NGOC LAPHONSE
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:5621 ST. HELENA PLACE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129
Mailing Address - Country:US
Mailing Address - Phone:504-388-1023
Mailing Address - Fax:504-368-3932
Practice Address - Street 1:2800 MANHATTAN BLVD STE D
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2904
Practice Address - Country:US
Practice Address - Phone:504-368-7513
Practice Address - Fax:504-368-3932
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA52671223X0400X
MS34081223X0400X
TX295621223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics