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NPI Code Detail

MEDICARE: DR. THAO THI NGO D.D.S.

MEDICARE: DR. THAO THI NGO D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry57074CA

General Provider Information

NPI Number : 1255522603
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THAO THI NGO D.D.S.
Provider Business Mailing Address
First Line : 15944 LOS SERRANOS COUNTRY CLUB DR STE 120
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-3254
Country : US
Telephone Number : 909-606-0853
Fax Number : 909-606-0854
Provider Business Practice Location Address
First Line : 15944 LOS SERRANOS COUNTRY CLUB DR STE 120
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-3254
Country : US
Telephone Number : 909-606-0853
Fax Number : 909-606-0854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2007
Last Update Date : 08/06/2020

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Directions to “ DR. THAO THI NGO D.D.S.” Practice Location

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