=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124813134
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY FRANCES NGO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2025
-----------------------------------------------------
Last Update Date | 04/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 845 QUINCE ORCHARD BLVD STE H
-----------------------------------------------------
City | GAITHERSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20878-1676
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-527-2727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3425 WINMOOR DR
-----------------------------------------------------
City | IJAMSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21754-9547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-687-3042
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | 7987
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------