Amy Wong D.D.S., Inc

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

56140 Issued in CA

Legal business name

AMY WONG D.D.S., INC

Practice address

1404 S San Gabriel Blvd Ste a
San Gabriel, CA 91776-3603

Phone

(626) 863-8578

NPI assigned

Feb 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Amy Wong, D.D.S.NPI 1740425677

Title

President

Phone

(626) 863-8575

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Amy Wong, DDS

  • Dentist
  • San Gabriel, CA
  • NPI 1740425677
  NPD (past) Authorized official

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1063734036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 S SAN GABRIEL BLVD STE A",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763603",
            "telephone_number": "626-863-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 S SAN GABRIEL BLVD STE A",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763603",
            "telephone_number": "626-863-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY WONG D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-863-8575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "56140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.