Provider Demographics
NPI:1285525741
Name:NGO, RYAN TOAN (DMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:TOAN
Last Name:NGO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 DINWIDDIE WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7424
Mailing Address - Country:US
Mailing Address - Phone:714-657-4163
Mailing Address - Fax:
Practice Address - Street 1:2280 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5531
Practice Address - Country:US
Practice Address - Phone:916-866-8363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist