Provider Demographics
NPI:1871690412
Name:NGO, TUYET THI (DMD)
Entity type:Individual
Prefix:DR
First Name:TUYET
Middle Name:THI
Last Name:NGO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N COUNTRY CLUB DR
Mailing Address - Street 2:SUITE # 7
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-2537
Mailing Address - Country:US
Mailing Address - Phone:480-833-2005
Mailing Address - Fax:480-833-9122
Practice Address - Street 1:1150 N COUNTRY CLUB DR
Practice Address - Street 2:SUITE # 7
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-2537
Practice Address - Country:US
Practice Address - Phone:480-833-2005
Practice Address - Fax:480-833-9122
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice