Individual provider Active NPI

Quang Minh Ngo

  • General Practice Dentistry
  • Fountain Valley, CA
National Provider Identifier
1790300267
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106779 Issued in CA
Practice address
11057 Warner Ave
Fountain Valley, CA 92708-4007
Phone
(714) 277-0449
NPI assigned
Jun 10, 2020
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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 106779 CA Primary

Addresses

Primary practice location

11057 Warner Ave
Fountain Valley, CA 92708-4007

Mailing address

11057 Warner Ave
Fountain Valley, CA 92708-4007
Phone (714) 277-0449

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
106779CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vivian C. Banaria, DMD, Inc. General Practice PastSince Feb 13, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1790300267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11057 WARNER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "714-277-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11057 WARNER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "714-277-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "QUANG",
        "middle_name": "MINH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.