Provider Demographics
NPI:1902858962
Name:HOANG, DUNG THIEN (MD)
Entity Type:Individual
Prefix:
First Name:DUNG
Middle Name:THIEN
Last Name:HOANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:THIEN
Other - Last Name:HOANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3848 VETERANS MEMORIAL BLVD 101
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5636
Mailing Address - Country:US
Mailing Address - Phone:504-885-2505
Mailing Address - Fax:504-885-2510
Practice Address - Street 1:3848 VETERANS MEMORIAL BLVD 101
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5636
Practice Address - Country:US
Practice Address - Phone:504-885-2505
Practice Address - Fax:504-885-2510
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA026156207RS0012X
LAMD026156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1140414Medicaid
LA1140414Medicaid
I37921Medicare UPIN