Individual provider Active NPI

Thuy Wiesner, D.D.S

  • General Practice Dentistry
  • Shreveport, LA
National Provider Identifier
1922202936
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5830 Issued in LA
Practice address
385 Bert Kouns Loop Ste 700
Shreveport, LA 71106-8163
Phone
(318) 688-9330
Fax
(318) 688-1183
NPI assigned
Jun 13, 2007
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5830 LA Primary

Addresses

Primary practice location

385 Bert Kouns Loop Ste 700
Shreveport, LA 71106-8163

Mailing address

385 Bert Kouns Loop Ste 700
Shreveport, LA 71106-8163
Phone (318) 688-9330

Other practice location 1

2557 Viking Dr
Bossier City, LA 71111-2103
Phone (318) 688-9330

Other practice location 2

1775 Jimmie Davis Hwy
Bossier City, LA 71112-4515
Phone (318) 688-9330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5830LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Michael R. Wiesner DDS LLC General Practice CurrentSince Oct 20, 2024 Accepting new patients
A Brighter Smile General Practice PastSince Sep 28, 2025 Accepting new patients

Locations

2557 Viking Dr
Bossier City, LA 71111
Phone (318) 688-9330

385 Bert Kouns Loop
Ste 700
Shreveport, LA 71106
Phone (318) 688-9330

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1922202936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 BERT KOUNS LOOP STE 700",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068163",
            "telephone_number": "318-688-9330",
            "fax_number": "318-688-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 BERT KOUNS LOOP STE 700",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068163",
            "telephone_number": "318-688-9330",
            "fax_number": "318-688-1183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2557 Viking Dr",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711112103",
            "country_code": "US",
            "telephone_number": "318-688-9330",
            "fax_number": "318-688-1183",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Jimmie Davis Hwy",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711124515",
            "country_code": "US",
            "telephone_number": "318-688-9330",
            "fax_number": "318-688-1183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESNER",
        "first_name": "THUY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.