Matthew C NG, DMD, MSD
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Lake Jackson, TX
NPI 1497975650 · NPPES record last updated Aug 12, 2008
Key facts
- NPI
- 1497975650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 23095 (TX)
- Practice address
- 207 Banyan St
Lake Jackson, TX 77566-4405 - Phone
- (604) 318-4688
- NPI assigned
- Apr 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23095 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 23095 | TX | Yes |
Addresses
Primary practice location
207 Banyan St
Lake Jackson, TX 77566-4405
Mailing address
1901 Post Oak Blvd
Unit #202
Houston, TX 77056-3868
Other providers in Lake Jackson, TX
- Fabiola Negrete
- Morgan Rae Seier Nelson
- Nephrology Nutrition Services
- New Horizon Care Home LLC
- Next Level Psychiatric Care Inc
- David Cao Nguyen
- Julie Thuydung Nguyen
- Nathan Nguyen
- Ngoc-Diep T Nguyen
- Nicholas B. Creel, M.D., P.a.
All providers in Lake Jackson, TX · Orthodontics and Dentofacial Orthopedics Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.