Active NPI
Elaine Genevieve Wong, D.M.D.
- General Practice Dentistry
- North Potomac, MD
National Provider Identifier
1053370726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11587
- Practice address
- 12201 Pissaro Dr
North Potomac, MD 20878-3475 - Phone
- (301) 208-8565
- Fax
- (301) 208-8565
- NPI assigned
- Mar 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11587 | MD | Primary |
Addresses
Primary practice location
12201 Pissaro Dr
North Potomac, MD 20878-3475
Mailing address
12201 Pissaro Dr
North Potomac, MD 20878-3475
Phone (301) 208-8565
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11587 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1053370726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12201 PISSARO DR",
"city": "NORTH POTOMAC",
"state": "MD",
"postal_code": "208783475",
"telephone_number": "301-208-8565",
"fax_number": "301-208-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12201 PISSARO DR",
"city": "NORTH POTOMAC",
"state": "MD",
"postal_code": "208783475",
"telephone_number": "301-208-8565",
"fax_number": "301-208-8565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "ELAINE",
"middle_name": "GENEVIEVE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "11587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Potomac, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.