Provider Demographics
NPI:1265564728
Name:NG, JOSEPH Y (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:Y
Last Name:NG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 120136
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02112-0136
Mailing Address - Country:US
Mailing Address - Phone:617-338-0833
Mailing Address - Fax:617-338-7177
Practice Address - Street 1:180 LINCOLN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-2400
Practice Address - Country:US
Practice Address - Phone:617-338-0833
Practice Address - Fax:617-338-7177
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice