Provider Demographics
NPI:1932703352
Name:NG, DESMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:DESMOND
Middle Name:
Last Name:NG
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 1:3 EMBARCADERO CENTER
Mailing Address - Street 2:PROMANADE LEVEL #4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-4003
Mailing Address - Country:US
Mailing Address - Phone:415-693-0888
Mailing Address - Fax:
Practice Address - Street 1:3 EMBARCADERO CENTER
Practice Address - Street 2:PROMANADE LEVEL #4
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4003
Practice Address - Country:US
Practice Address - Phone:415-693-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1058021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice