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General NPI Number Information
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NPI Number | 1548303241
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Entity Type | Individual
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Provider Name | PHUONG NGOC LAPHONSE NGUYEN D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 02/14/2014
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Provider Practice Location Address
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Address Line | 2800 MANHATTAN BLVD STE D
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City | HARVEY
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State | LA
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Zip | 70058-2904
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Country | US
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Telephone | 504-368-7513
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Fax | 504-368-3932
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Provider Business Mailing Address
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Address Line | 5621 ST. HELENA PLACE
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City | NEW ORLEANS
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State | LA
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Zip | 70129
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Country | US
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Telephone | 504-388-1023
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Fax | 504-368-3932
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5267
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 3408
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 29562
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License Number State | TX
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