Wesley E Wong, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

45792 Issued in CA

Practice address

4101 Tully Rd
Suite 201
Modesto, CA 95356-8980

Phone

(209) 577-0777

NPI assigned

Jan 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rickey & Wong, D.D.S., Inc.

  • General Practice Dentistry
  • Modesto, CA
  • NPI 1235551342
  NPD (past)

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1083984942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 PALAZZO CT",
            "address_2": "SUITE 201",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TULLY RD",
            "address_2": "SUITE 201",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568980",
            "telephone_number": "209-577-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "WESLEY",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda F Wong
• Patrick Wong Jr., D.O
• Stephanie Shu Fen Wong
• Taylor Wong
• Tze Ying Megan Wong
• Grace Woo, DDS
• Jordan Tyler Woo
• Lang Woo
• Charles Evans Wood, L.C.S.W.
• Jacob Wood

• Dentist in Modesto, CA
• Providers in Modesto, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.