Provider Demographics
NPI:1831459866
Name:NGUYEN, QUYNH THE (DDS)
Entity Type:Individual
Prefix:DR
First Name:QUYNH
Middle Name:THE
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 1:3833 GENTILLY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-6129
Mailing Address - Country:US
Mailing Address - Phone:504-613-8922
Mailing Address - Fax:
Practice Address - Street 1:800 C M FAGAN DR
Practice Address - Street 2:SUITE A
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:985-345-5088
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6286122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist