Individual provider Active NPI

Christine N Wong, DDS

  • Periodontics
  • New York, NY
National Provider Identifier
1093073637
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
056838-1 Issued in NY
Practice address
110 E 40TH St RM 104
New York, NY 10016
Phone
(212) 682-2965
NPI assigned
May 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 056838-1 NY Primary
Periodontics 1223P0300X 22DI02671600 NJ

Addresses

Primary practice location

110 E 40TH St RM 104
New York, NY 10016

Mailing address

1563 Parker Ave
Fort Lee, NJ 07024-7002
Phone (201) 461-4133

Other practice location 1

139 Centre St
Suite 602
New York, NY 10013
Phone (212) 966-5726

Other practice location 2

491 Amwell Rd Ste 204
Hillsborough, NJ 08844-8212
Phone (908) 431-0000

Other identifiers 1

IdentifierTypeStateIssuer
03709102MedicaidNY

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

LicenseStateTypeSpecialty
22DI02671600NJMDPeriodontist
056838-1NYMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Dental Group PC Periodontics CurrentSince Apr 6, 2021 Accepting new patients
Yeung's Dental Care P.C. Past Accepting new patients
Precision Dental, PC Past Accepting new patients
Expert Dental PC PastSince Nov 1, 2020 Accepting new patients
Cory a. Wanatick,D.M.D.,P.a. Periodontics Past Accepting new patients

Locations

491 Amwell Rd
Ste 204
Hillsborough, NJ 08844
Phone (908) 431-0000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1093073637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 PARKER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247002",
            "telephone_number": "201-461-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 40TH ST RM 104",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-682-2965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "139 Centre St",
            "address_2": "Suite 602",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10013",
            "country_code": "US",
            "telephone_number": "212-966-5726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "491 Amwell Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Hillsborough",
            "state": "NJ",
            "postal_code": "088448212",
            "country_code": "US",
            "telephone_number": "908-431-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHRISTINE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "056838-1",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02671600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03709102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.

Verify at the official NPI Registry.