NPIMap

Organization Active NPI

Olson Wong, PLLC.

  • Oral Medicine Dentistry
  • Bellevue, WA
National Provider Identifier
1023849544
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral Medicine DentistryTaxonomy code 125Q00000X
Legal business name
OLSON WONG, PLLC.
Practice address
2020 116TH Ave NE Ste 150
Bellevue, WA 98004-3059
Phone
(425) 300-9056
Fax
(425) 300-9057
NPI assigned
Aug 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jacqueline J Wong, DDS, MSDNPI 1417315490
Title
Co-Owner
Phone
(253) 234-4230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral Medicine DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 125Q00000X Primary

Addresses

Primary practice location

2020 116TH Ave NE Ste 150
Bellevue, WA 98004-3059

Mailing address

2020 116TH Ave NE Ste 150
Bellevue, WA 98004-3059
Phone (425) 300-9056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240823001949 WA Part B Supplier - Clinic/Group Practice 0446799308 Receives reassigned benefits from 3 practitioners
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1023849544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 116TH AVE NE STE 150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043059",
            "telephone_number": "425-300-9056",
            "fax_number": "425-300-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 116TH AVE NE STE 150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043059",
            "telephone_number": "425-300-9056",
            "fax_number": "425-300-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLSON WONG, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "253-234-4230",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "125Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.