Provider Demographics
NPI:1700067188
Name:NGO, HOWARD T (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:T
Last Name:NGO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11351 RANDOM HILLS RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6081
Mailing Address - Country:US
Mailing Address - Phone:703-865-6677
Mailing Address - Fax:703-865-6680
Practice Address - Street 1:11351 RANDOM HILLS RD
Practice Address - Street 2:SUITE 290
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6081
Practice Address - Country:US
Practice Address - Phone:703-865-6677
Practice Address - Fax:703-865-6680
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43881223G0001X
VA04014118361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice