Provider Demographics
NPI:1083795769
Name:NGO, VINH T (DDS)
Entity Type:Individual
Prefix:
First Name:VINH
Middle Name:T
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 1:22 NEW MDWS
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-7537
Mailing Address - Country:US
Mailing Address - Phone:949-559-9377
Mailing Address - Fax:
Practice Address - Street 1:17240 DOWNEY AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6105
Practice Address - Country:US
Practice Address - Phone:562-531-0221
Practice Address - Fax:562-531-1262
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA491591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice