Provider Demographics
NPI:1053532408
Name:NGO, TIEN THUY (DMD)
Entity type:Individual
Prefix:DR
First Name:TIEN
Middle Name:THUY
Last Name:NGO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 E VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1632
Mailing Address - Country:US
Mailing Address - Phone:805-485-1519
Mailing Address - Fax:
Practice Address - Street 1:2840 E VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1632
Practice Address - Country:US
Practice Address - Phone:805-485-1519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice