Individual provider Active NPI

Stanley T Ngo, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1114078490
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20604 Issued in TX
Practice address
9780 Walnut St
Ste 188
Dallas, TX 75243-2389
Phone
(469) 330-9968
Fax
(469) 330-7800
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20604 TX Primary

Addresses

Primary practice location

9780 Walnut St
Ste 188
Dallas, TX 75243-2389

Mailing address

9780 Walnut St
Ste 188
Dallas, TX 75243
Phone (469) 330-9968

Other identifiers 2

IdentifierTypeStateIssuer
1465243OtherTXUNITED CONCORDIA'S PIN
157086302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150522000227 TX Order and Referring Only - DentistPractitioner - Dentist 0042530669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20604TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley Ngo, D.D.S., P.a. General Practice CurrentSince Mar 1, 2003 Accepting new patients

Locations

9780 Walnut St
Ste 188
Dallas, TX 75243
Phone (469) 330-9968

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1114078490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9780 WALNUT ST",
            "address_2": "STE 188",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "469-330-9968",
            "fax_number": "469-330-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9780 WALNUT ST",
            "address_2": "STE 188",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752432389",
            "telephone_number": "469-330-9968",
            "fax_number": "469-330-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "STANLEY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA'S PIN",
            "identifier": "1465243",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157086302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.