Provider Demographics
NPI:1316337942
Name:NGO, STEVE Q (DDS)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:Q
Last Name:NGO
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 1:1310 BISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-9070
Mailing Address - Country:US
Mailing Address - Phone:949-760-0363
Mailing Address - Fax:949-760-0365
Practice Address - Street 1:1310 BISON AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-9070
Practice Address - Country:US
Practice Address - Phone:949-760-0363
Practice Address - Fax:949-760-0365
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44425122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist