Provider Demographics
NPI:1255903530
Name:NG, ERIK PHUC-YUAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:PHUC-YUAN
Last Name:NG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 SULLIVAN CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-3859
Mailing Address - Country:US
Mailing Address - Phone:817-437-0578
Mailing Address - Fax:
Practice Address - Street 1:1250 E PIONEER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6422
Practice Address - Country:US
Practice Address - Phone:817-265-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX375071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice