Provider Demographics
NPI:1982223491
Name:NG, ANDREW JONATHAN (DMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JONATHAN
Last Name:NG
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 1:921 HADDONFIELD RD STE 2D
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2782
Mailing Address - Country:US
Mailing Address - Phone:856-250-1001
Mailing Address - Fax:
Practice Address - Street 1:100 S BROAD ST STE 1530
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-1026
Practice Address - Country:US
Practice Address - Phone:215-383-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002047101223G0001X
NJ22DI030778001223X0400X
390200000X
MI2951000925390200000X
PADS0453091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program