Provider Demographics
NPI:1003210881
Name:NGO, THUY B (DMD)
Entity type:Individual
Prefix:
First Name:THUY
Middle Name:B
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 1:4550 E. BELL RD.
Mailing Address - Street 2:#102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-485-1588
Mailing Address - Fax:602-707-9740
Practice Address - Street 1:4550 E. BELL RD.
Practice Address - Street 2:#102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:602-485-1588
Practice Address - Fax:602-707-9740
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0045061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice