Provider Demographics
NPI:1255172326
Name:NG, CHRISTY (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:NG
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 1:1500 E MEDICAL CENTER DRIVE
Mailing Address - Street 2:C213 MEDINN, SPC 5831
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5831
Mailing Address - Country:US
Mailing Address - Phone:734-936-5950
Mailing Address - Fax:734-232-5015
Practice Address - Street 1:1500 E MEDICAL CENTER DRIVE
Practice Address - Street 2:C213 MEDINN, SPC 5831
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5831
Practice Address - Country:US
Practice Address - Phone:734-936-5950
Practice Address - Fax:734-232-5015
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2951000957390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program