Provider Demographics
NPI:1114078490
Name:NGO, STANLEY T (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:T
Last Name:NGO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4715 JACKSON MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-4590
Mailing Address - Country:US
Mailing Address - Phone:469-879-4264
Mailing Address - Fax:469-330-7800
Practice Address - Street 1:9780 WALNUT ST
Practice Address - Street 2:STE. #188
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2389
Practice Address - Country:US
Practice Address - Phone:469-330-9968
Practice Address - Fax:469-330-7800
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1465243OtherUNITED CONCORDIA'S PIN