Provider Demographics
NPI:1386210250
Name:NGUYEN, ANTHONY HIEU (DDS)
Entity Type:Individual
Prefix:
First Name:ANTHONY HIEU
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4872 ALCEE FORTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-1602
Mailing Address - Country:US
Mailing Address - Phone:504-450-7688
Mailing Address - Fax:
Practice Address - Street 1:800 C M FAGAN DR STE A
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6062
Practice Address - Country:US
Practice Address - Phone:985-345-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist