Provider Demographics
NPI:1962980961
Name:NGO, CALVIN WAH (DMD)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:WAH
Last Name:NGO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17474 BAYFLOWER
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-2238
Mailing Address - Country:US
Mailing Address - Phone:832-290-3936
Mailing Address - Fax:
Practice Address - Street 1:500 W MONTGOMERY ST STE B
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77378-8827
Practice Address - Country:US
Practice Address - Phone:936-701-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0101091223G0001X
TX349091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice