Provider Demographics
NPI:1023290988
Name:NGO, YOUNG QUOC (DDS)
Entity type:Individual
Prefix:MR
First Name:YOUNG
Middle Name:QUOC
Last Name:NGO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:DUNG
Other - Middle Name:QUOC
Other - Last Name:NGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5100 OBYRNES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:CA
Mailing Address - Zip Code:95327-9102
Mailing Address - Country:US
Mailing Address - Phone:209-984-5291
Mailing Address - Fax:
Practice Address - Street 1:5100 OBYRNES FERRY RD
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:CA
Practice Address - Zip Code:95327-9102
Practice Address - Country:US
Practice Address - Phone:209-984-5291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48968122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist