MEDICARE: LANA H TUONG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		TX
2	1223G0001X	General Practice Dentistry	39708	TX

General Provider Information

NPI Number	:	1518668292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANA H TUONG DDS

Provider Business Mailing Address
First Line	:	2430 NW MILITARY HWY APT 2504
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78231-2519
Country	:	US
Telephone Number	:	510-396-5565
Fax Number	:

Provider Business Practice Location Address
First Line	:	5515 TEZEL RD STE 106
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-4143
Country	:	US
Telephone Number	:	210-864-8241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2023
Last Update Date	:	07/20/2023

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Directions to “ LANA H TUONG DDS” Practice Location

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