Healthcare Provider Details

I. General information

NPI: 1710873716
Provider Name (Legal Business Name): DZUY LUU PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 E 3175 N
LAYTON UT
84040-7325
US

IV. Provider business mailing address

1513 E 3175 N
LAYTON UT
84040-7325
US

V. Phone/Fax

Practice location:
  • Phone: 702-723-6588
  • Fax:
Mailing address:
  • Phone: 702-723-6588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. DZUY LUU
Title or Position: OWNER
Credential: PA
Phone: 702-723-6588