Provider Demographics
NPI:1386027738
Name:NGO, LINH THI THUY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINH
Middle Name:THI THUY
Last Name:NGO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 W PINHOOK RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3735
Mailing Address - Country:US
Mailing Address - Phone:337-235-3761
Mailing Address - Fax:337-234-9327
Practice Address - Street 1:116 RUE BEAUREGARD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3102
Practice Address - Country:US
Practice Address - Phone:337-235-3761
Practice Address - Fax:337-234-9327
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice