James Wong Dental Corp.

Organization Active NPI General Practice Dentistry · Maywood, CA

NPI 1073667945 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1073667945
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
42713 (CA)
Legal business name
JAMES WONG DENTAL CORP.
Practice address
4509 E. Slauson Ave Ste B
Maywood, CA 90270-2954
Phone
(323) 771-6000
NPI assigned
Jan 22, 2007
Organization subpart
No

Authorized official

Name
Dr. James T Wong, DDS
Title
Dentist
Phone
(323) 771-6000

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Corona Dental Center (2 organizations share this tax ID)

Locations

4509 Slauson Ave
Ste B
Maywood, CA 90270
Phone (323) 560-8999

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223G0001X 42713 CA Yes

Addresses

Primary practice location

4509 E. Slauson Ave Ste B
Maywood, CA 90270-2954

Mailing address

4509 E. Slauson Ave Ste B
Maywood, CA 90270-2954
Phone (323) 771-6000

Other identifiers

IdentifierTypeStateIssuer
G93151-02MedicaidCA

Other names

  • Maywood Dental Center Doing business as

Other providers in Maywood, CA

All providers in Maywood, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.