Provider Demographics
NPI:1356394910
Name:CHAO, WA NGOY (DDS)
Entity type:Individual
Prefix:DR
First Name:WA
Middle Name:NGOY
Last Name:CHAO
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 1:1055 N LA CANADA DR
Mailing Address - Street 2:STE. 109
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-3700
Mailing Address - Country:US
Mailing Address - Phone:520-399-2700
Mailing Address - Fax:520-399-4001
Practice Address - Street 1:1055 N LA CANADA DR
Practice Address - Street 2:STE. 109
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-3700
Practice Address - Country:US
Practice Address - Phone:520-399-2700
Practice Address - Fax:520-399-4001
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD59861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice