Provider Demographics
NPI:1609926435
Name:NG, CATHERINE W (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:W
Last Name:NG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:W
Other - Last Name:YING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15 FAIRPOINT DR
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-2153
Mailing Address - Country:US
Mailing Address - Phone:585-388-7907
Mailing Address - Fax:
Practice Address - Street 1:2615 CULVER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-1746
Practice Address - Country:US
Practice Address - Phone:585-467-2745
Practice Address - Fax:585-467-5683
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050283-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY70672CNOtherBLUECROSS BLUESHIELD #