Joonho Phiyo

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7209 Issued in LA

Practice address

3719 Jewella Ave
Shreveport, LA 71109-4703

Phone

(318) 758-9123

NPI assigned

Feb 8, 2021

Last updated

Mar 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1235721523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 JEWELLA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711094703",
            "telephone_number": "318-758-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 JEWELLA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711094703",
            "telephone_number": "318-758-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIYO",
        "first_name": "JOONHO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7209",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "7209",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karoline Phillips
• Lea Ann Phillips, NP
• Lloyd Phillips, M.D.
• Trandi Lynette Phillips
• Veronica Phillips
• Phoenix Health Services, LLC
• Physicians Behavioral Hospital, LLC (Physicians Behavioral Hospital)
• Patricia Pichilingue Reto, MD
• Polly Lynn Pickard
• Vicki Su Pickard, M.S., P.T.

• General Practice Dentistry in Shreveport, LA
• Providers in Shreveport, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.