Provider Demographics
NPI:1285928978
Name:NGUYEN, KIM-HANH NGOC (DDS)
Entity type:Individual
Prefix:DR
First Name:KIM-HANH
Middle Name:NGOC
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 1:5760 HAYNE BLVD.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126
Mailing Address - Country:US
Mailing Address - Phone:504-514-8457
Mailing Address - Fax:
Practice Address - Street 1:5760 HAYNE BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1252
Practice Address - Country:US
Practice Address - Phone:504-241-8457
Practice Address - Fax:504-241-8450
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice