Provider Demographics
NPI:1982746046
Name:NGO, TRANG XUAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRANG
Middle Name:XUAN
Last Name:NGO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 KIPLING ST
Mailing Address - Street 2:STE 510
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2321
Mailing Address - Country:US
Mailing Address - Phone:303-543-8338
Mailing Address - Fax:720-382-1289
Practice Address - Street 1:5111 KIPLING ST
Practice Address - Street 2:STE 510
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2321
Practice Address - Country:US
Practice Address - Phone:303-543-8338
Practice Address - Fax:720-382-1289
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222481223G0001X
CO101511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOTPI143328AMedicaid