Provider Demographics
NPI:1962801886
Name:NGO, QUYNH NHI PHUOC (DMD)
Entity type:Individual
Prefix:
First Name:QUYNH
Middle Name:NHI PHUOC
Last Name:NGO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 ORANGETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3437
Mailing Address - Country:US
Mailing Address - Phone:714-994-1000
Mailing Address - Fax:714-994-1001
Practice Address - Street 1:7990 ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3437
Practice Address - Country:US
Practice Address - Phone:714-994-1000
Practice Address - Fax:714-994-1001
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA635241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice