Provider Demographics
NPI:1194866160
Name:NGO & NGUYEN, APDC
Entity Type:Organization
Organization Name:NGO & NGUYEN, APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THUC
Authorized Official - Middle Name:XUAN
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-855-4701
Mailing Address - Street 1:15251 GALE AVE
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91745-1507
Mailing Address - Country:US
Mailing Address - Phone:626-855-4701
Mailing Address - Fax:626-855-4703
Practice Address - Street 1:15251 GALE AVE
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91745-1507
Practice Address - Country:US
Practice Address - Phone:626-855-4701
Practice Address - Fax:626-855-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457391223G0001X
CA476451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty