Phonsuda Chanthavisouk is a Minneapolis, Minnesota based oral hygienist who is specialized as Hygienist. Active license number of Phonsuda Chanthavisouk is DT137 in Minnesota. Her current practice location is 728 E Hennepin Ave, Minneapolis. Patients can reach her at 612-746-1530.
Phonsuda Chanthavisouk has completed an accredited dental hygiene education program, and has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions of dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary
Complete Profile:
Phonsuda Chanthavisouk speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Phonsuda Chanthavisouk |
| Specialization: | Dental Hygienist |
| Gender: | Female |
| Credentials: | RDH, MDT |
| Practice Address: | 728 E Hennepin Ave, Minneapolis,
Minnesota, 55414-1126 |
| Phone: | 612-746-1530 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1548844053 |
| NPI Enumeration Date: | 11 May, 2021 |
| NPI Last Update On: | 08 Aug, 2023 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Phonsuda Chanthavisouk are as mentioned below.
| License Number | Specialization | State | Status | |
| DT137 | | Minnesota | Primary | |
| H11002 | Dental Hygienist | Minnesota | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Phonsuda Chanthavisouk such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| DT137 | Medicaid | Minnesota | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 6145 14th Ave S,
Minneapolis, Minnesota |
| Zip: | 55423-1728 |
| Phone Number: | 612-961-9886 |
Patients can reach Phonsuda Chanthavisouk at
728 E Hennepin Ave, Minneapolis, Minnesota or can
call to book an appointment on 612-746-1530.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.