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General NPI Number Information
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NPI Number | 1598907586
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Entity Type | Organization
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Legal Business Name | JIMMY VU NGO D.D.S., INC
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 10562 WESTMINSTER AVENUE SUITE #B
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4800
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Country | US
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Telephone | 714-530-8577
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Fax | 714-530-8578
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Provider Business Mailing Address
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Address Line | 10562 WESTMINSTER AVE STE B
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4864
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Country | US
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Telephone | 714-530-8577
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Fax | 714-530-8578
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. JIMMY NGO
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Credential | D.D.S
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Telephone | 714-530-8577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 40395
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License Number State | CA
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