Provider Demographics
NPI:1144522061
Name:NG, MARIA PHUNG-QUYEN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:PHUNG-QUYEN
Last Name:NG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18040 SHERMAN WAY STE 330
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4626
Mailing Address - Country:US
Mailing Address - Phone:424-336-0060
Mailing Address - Fax:424-336-0045
Practice Address - Street 1:18040 SHERMAN WAY STE 330
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4626
Practice Address - Country:US
Practice Address - Phone:424-336-0060
Practice Address - Fax:424-336-0045
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1058211223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics