Healthcare Provider Details

I. General information

NPI: 1780313056
Provider Name (Legal Business Name): LARRY HOANG NGO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 W 38TH AVE STE 50
DENVER CO
80211-2000
US

IV. Provider business mailing address

3550 W 38TH AVE STE 50
DENVER CO
80211-2000
US

V. Phone/Fax

Practice location:
  • Phone: 303-515-7008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN.00205163
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: