Provider Demographics
NPI:1760584379
Name:NGAN, AMANDA YU-WEI (DDS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:YU-WEI
Last Name:NGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23033 LYONS AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2776
Mailing Address - Country:US
Mailing Address - Phone:661-255-0408
Mailing Address - Fax:
Practice Address - Street 1:23033 LYONS AVE STE 5
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2776
Practice Address - Country:US
Practice Address - Phone:661-255-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555671223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics