MEDICARE: DR. LINDA NGO DDS

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
1	122300000X	Dentist	055363	NY

General Provider Information

NPI Number	:	1790912558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA NGO DDS

Provider Business Mailing Address
First Line	:	178 THOMPSON ST
Second Line	:	APT 6A
City	:	NEW YORK
State	:	NY
Zip	:	10012-4912
Country	:	US
Telephone Number	:	949-331-7556
Fax Number	:	949-331-7556

Provider Business Practice Location Address
First Line	:	178 THOMPSON ST
Second Line	:	APT 6A
City	:	NEW YORK
State	:	NY
Zip	:	10012-4912
Country	:	US
Telephone Number	:	949-331-7556
Fax Number	:	949-331-7556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2009
Last Update Date	:	06/10/2013

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Directions to “ DR. LINDA NGO DDS” Practice Location

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