Active NPI
Sam Ngo
- General Practice Dentistry
- Lancaster, CA
National Provider Identifier
1073002184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI02740600
- Practice address
- 45124 10TH St W
Lancaster, CA 93534-2310 - Phone
- (562) 867-7999
- NPI assigned
- May 3, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 22DI02740600 | NJ | Primary |
Addresses
Primary practice location
45124 10TH St W
Lancaster, CA 93534-2310
Mailing address
5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516
Other practice location 1
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5593
Other practice location 2
1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144
Other practice location 3
30 Prospect Ave
Hackensack, NJ 07601
Phone (551) 996-5593
Other practice location 4
1771 Madison Ave
Lakewood, NJ 08701-1242
Phone (732) 364-6666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- san.ngodmd.d1.p1@direct.jwch.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1073002184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5650 JILLSON ST",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900401482",
"telephone_number": "323-201-4516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45124 10TH ST W",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935342310",
"telephone_number": "562-867-7999"
}
],
"practiceLocations": [
{
"address_1": "30 Prospect Ave",
"address_purpose": "LOCATION",
"city": "Hackensack",
"state": "NJ",
"postal_code": "076011915",
"country_code": "US",
"telephone_number": "551-996-5593",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1771 Madison Ave",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "NJ",
"postal_code": "08701",
"country_code": "US",
"telephone_number": "732-364-2144",
"fax_number": "732-364-3559",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "30 Prospect Ave",
"address_purpose": "LOCATION",
"city": "Hackensack",
"state": "NJ",
"postal_code": "07601",
"country_code": "US",
"telephone_number": "551-996-5593",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1771 Madison Ave",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "NJ",
"postal_code": "087011242",
"country_code": "US",
"telephone_number": "732-364-6666",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGO",
"first_name": "SAM",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-03",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02740600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.