Provider Demographics
NPI:1366702714
Name:NGUYEN, THUNGA THI (DDS)
Entity type:Individual
Prefix:MRS
First Name:THUNGA
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 YMCA PLAZA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0940
Mailing Address - Country:US
Mailing Address - Phone:225-768-8200
Mailing Address - Fax:225-768-8070
Practice Address - Street 1:8160 YMCA PLAZA DR
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-0940
Practice Address - Country:US
Practice Address - Phone:225-768-8200
Practice Address - Fax:225-768-8070
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-19
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA62801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1862801Medicaid