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:
Oral 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
Oral 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. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.