Provider Demographics
NPI:1336352285
Name:TUYET NGO, DMD, PLLC
Entity Type:Organization
Organization Name:TUYET NGO, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TUYET
Authorized Official - Middle Name:
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-833-2005
Mailing Address - Street 1:1150 N COUNTRY CLUB DR
Mailing Address - Street 2:SUITE # 7
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-2537
Mailing Address - Country:US
Mailing Address - Phone:480-833-2005
Mailing Address - Fax:480-833-9122
Practice Address - Street 1:1150 N COUNTRY CLUB DR
Practice Address - Street 2:SUITE # 7
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-2537
Practice Address - Country:US
Practice Address - Phone:480-833-2005
Practice Address - Fax:480-833-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty