Provider Demographics
NPI:1396883849
Name:LY, VANG NENG (DDS)
Entity type:Individual
Prefix:MR
First Name:VANG
Middle Name:NENG
Last Name:LY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:1355 FLORIN RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-4231
Mailing Address - Country:US
Mailing Address - Phone:916-399-9910
Mailing Address - Fax:916-399-8961
Practice Address - Street 1:1355 FLORIN RD
Practice Address - Street 2:SUITE 6
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4231
Practice Address - Country:US
Practice Address - Phone:916-399-9910
Practice Address - Fax:916-399-8961
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA477541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice