Provider Demographics
NPI:1871845792
Name:VINH NGO DDS PLLC
Entity Type:Organization
Organization Name:VINH NGO DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-671-2213
Mailing Address - Street 1:4055 HOGAN DR
Mailing Address - Street 2:3102
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75709-6930
Mailing Address - Country:US
Mailing Address - Phone:212-671-2213
Mailing Address - Fax:
Practice Address - Street 1:1505 E RIO GRANDE ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-7396
Practice Address - Country:US
Practice Address - Phone:212-671-2213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27025122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty