MEDICARE: ANDREW JONATHAN NG DMD

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	1223G0001X	General Practice Dentistry	DEN.00204710	CO
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	22DI03077800	NJ
3	390200000X	Student in an Organized Health Care Education/Training Program
4	390200000X	Student in an Organized Health Care Education/Training Program	2951000925	MI
5	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS045309	PA

General Provider Information

NPI Number	:	1982223491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW JONATHAN NG DMD

Provider Business Mailing Address
First Line	:	921 HADDONFIELD RD STE 2D
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08002-2782
Country	:	US
Telephone Number	:	856-250-1001
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S BROAD ST STE 1530
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19110-1026
Country	:	US
Telephone Number	:	215-383-9800
Fax Number	:

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

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	07/28/2025

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