Healthcare Provider Details
I. General information
NPI: 1760308506
Provider Name (Legal Business Name): QUANG NGO DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11057 WARNER AVE
FOUNTAIN VALLEY CA
92708-4007
US
IV. Provider business mailing address
11057 WARNER AVE
FOUNTAIN VALLEY CA
92708-4007
US
V. Phone/Fax
- Phone: 714-531-5604
- Fax:
- Phone: 714-531-5604
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
QUANG
NGO
Title or Position: OWNER
Credential: DDS
Phone: 714-531-5604