Provider Demographics
NPI:1053316323
Name:NGO, LAM GIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAM
Middle Name:GIA
Last Name:NGO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14551 W. INDIAN SCHOOL RD.
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395
Mailing Address - Country:US
Mailing Address - Phone:623-535-8777
Mailing Address - Fax:623-535-8776
Practice Address - Street 1:14551 W. INDIAN SCHOOL RD.
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395
Practice Address - Country:US
Practice Address - Phone:623-535-8777
Practice Address - Fax:623-535-8777
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA486491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice