Provider Demographics
NPI:1790912558
Name:NGO, LINDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:NGO
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 1:178 THOMPSON ST
Mailing Address - Street 2:APT 6A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-4912
Mailing Address - Country:US
Mailing Address - Phone:949-331-7556
Mailing Address - Fax:949-331-7556
Practice Address - Street 1:178 THOMPSON ST
Practice Address - Street 2:APT 6A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4912
Practice Address - Country:US
Practice Address - Phone:949-331-7556
Practice Address - Fax:949-331-7556
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist