Individual provider Active NPI

Phuong Lan Ngo, D.D.S.

  • General Practice Dentistry
  • Garland, TX
National Provider Identifier
1417184763
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24750 Issued in TX
Practice address
3443 W Campbell Rd
Ste 650
Garland, TX 75044-8145
Phone
(972) 414-1515
Fax
(972) 414-1818
NPI assigned
Jun 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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 24750 TX Primary

Addresses

Primary practice location

3443 W Campbell Rd
Ste 650
Garland, TX 75044-8145

Mailing address

3306 Owens Blvd
Richardson, TX 75082-3030
Phone (214) 926-1290

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24750TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Phuong Lan Ngo DDS PA General Practice PastSince Jul 7, 2024 Accepting new patients

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": "1244937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1417184763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 OWENS BLVD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823030",
            "telephone_number": "214-926-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 W CAMPBELL RD",
            "address_2": "STE 650",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750448145",
            "telephone_number": "972-414-1515",
            "fax_number": "972-414-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "PHUONG",
        "middle_name": "LAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-14",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.

Verify at the official NPI Registry.