Active NPI
Brandon Pok Wong, DDS
- Dentist
- Taylor, MI
National Provider Identifier
1083134498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901600248
- Practice address
- 10700 Pelham Rd
Taylor, MI 48180-3827 - Phone
- (313) 388-1100
- NPI assigned
- Jun 27, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2901600248 | MI | Primary |
Addresses
Primary practice location
10700 Pelham Rd
Taylor, MI 48180-3827
Mailing address
10700 Pelham Rd
Taylor, MI 48180-3827
Phone (313) 388-1100
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901600248 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1083134498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10700 PELHAM RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481803827",
"telephone_number": "313-388-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10700 PELHAM RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481803827",
"telephone_number": "313-388-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "BRANDON",
"middle_name": "POK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-27",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901600248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.