Provider Demographics
NPI:1497993265
Name:STEVE Q. NGO, D.D.S., INCORPORATED
Entity Type:Organization
Organization Name:STEVE Q. NGO, D.D.S., INCORPORATED
Other - Org Name:IMAGE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-501-9863
Mailing Address - Street 1:10 INGLESIDE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2890
Mailing Address - Country:US
Mailing Address - Phone:949-760-0363
Mailing Address - Fax:949-760-0365
Practice Address - Street 1:1310 BISON AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-9070
Practice Address - Country:US
Practice Address - Phone:949-760-0363
Practice Address - Fax:949-760-0365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-31
Last Update Date:2009-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty