Provider Demographics
NPI:1235382003
Name:NANCY NGA LUU DDS INC
Entity Type:Organization
Organization Name:NANCY NGA LUU DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY NGA
Authorized Official - Middle Name:THI
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-686-8626
Mailing Address - Street 1:9641 E STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2564
Mailing Address - Country:US
Mailing Address - Phone:916-686-8626
Mailing Address - Fax:916-686-8634
Practice Address - Street 1:9641 E STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2564
Practice Address - Country:US
Practice Address - Phone:916-686-8626
Practice Address - Fax:916-686-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48953122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty