Provider Demographics
NPI:1952460446
Name:THAI, PAUL HUYPHUOC (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HUYPHUOC
Last Name:THAI
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 1:408 GRIFFIT ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8411
Mailing Address - Country:US
Mailing Address - Phone:612-298-4928
Mailing Address - Fax:
Practice Address - Street 1:18315 CASCADE DR STE 120
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1190
Practice Address - Country:US
Practice Address - Phone:952-949-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND113011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN687684600Medicaid