Healthcare Provider Details

I. General information

NPI: 1528998473
Provider Name (Legal Business Name): ANH-TUAN ANDY NGUYEN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14243 HIGHWAY 90
BOUTTE LA
70039-3517
US

IV. Provider business mailing address

5251 MICHOUD BLVD
NEW ORLEANS LA
70129-1423
US

V. Phone/Fax

Practice location:
  • Phone: 985-758-5110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7799
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: