Provider Demographics
NPI:1659783066
Name:VAN, TOAN CHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOAN
Middle Name:CHI
Last Name:VAN
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 1:2750 MILLERVILLE RD APT 11203
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-0108
Mailing Address - Country:US
Mailing Address - Phone:504-812-9488
Mailing Address - Fax:
Practice Address - Street 1:18502 W BELLFORT ST STE 112
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-9003
Practice Address - Country:US
Practice Address - Phone:832-378-7870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA64661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice