Provider Demographics
NPI:1710003256
Name:NGUYEN, VINH THANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINH
Middle Name:THANH
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 1:3709 WESTBANK EXRESSWAY SUITE 1A
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058
Mailing Address - Country:US
Mailing Address - Phone:504-347-7491
Mailing Address - Fax:
Practice Address - Street 1:3709 WESTBANK EXPY
Practice Address - Street 2:SUITE 1A
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2600
Practice Address - Country:US
Practice Address - Phone:504-347-7491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA51301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice