Individual provider Active NPI

Phuong Lien Ngo, D.D.S.

  • General Practice Dentistry
  • West Sacramento, CA
National Provider Identifier
1477758167
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36183 Issued in CA
Practice address
1001 Jefferson Blvd Ste 300
West Sacramento, CA 95691-3387
Phone
(916) 372-7022
Fax
(916) 372-7226
NPI assigned
Jun 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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 36183 CA Primary

Addresses

Primary practice location

1001 Jefferson Blvd Ste 300
West Sacramento, CA 95691-3387

Mailing address

1001 Jefferson Blvd Ste 300
West Sacramento, CA 95691-3387
Phone (916) 372-7022

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

Interoperability endpoints

  • Direct secure messaging: pngo@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1477758167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JEFFERSON BLVD STE 300",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913387",
            "telephone_number": "916-372-7022",
            "fax_number": "916-372-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JEFFERSON BLVD STE 300",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913387",
            "telephone_number": "916-372-7022",
            "fax_number": "916-372-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "PHUONG",
        "middle_name": "LIEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.