Provider Demographics
NPI:1932402278
Name:DO NG DENTAL, INC.
Entity Type:Organization
Organization Name:DO NG DENTAL, INC.
Other - Org Name:HUALAPAI DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TUYEN
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST/ GENERAL PRA
Authorized Official - Phone:702-221-4236
Mailing Address - Street 1:4280 SOUTH HUALAPAI WAY
Mailing Address - Street 2:STE. 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147
Mailing Address - Country:US
Mailing Address - Phone:702-221-4236
Mailing Address - Fax:702-222-0194
Practice Address - Street 1:4280 HUALAPAI WAY
Practice Address - Street 2:101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147
Practice Address - Country:US
Practice Address - Phone:702-221-4236
Practice Address - Fax:702-222-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV45921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
100507147Medicare UPIN