Perry S Wong, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

41327 Issued in CA

Practice address

Mariposa Indian Health Clinic
5192 Hospital Road
Mariposa, CA 95338-1569

Phone

(209) 966-0573

Fax

(209) 742-6321

NPI assigned

Aug 11, 2005

Last updated

Oct 13, 2021By the provider in NPPES

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1144222084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MARIPOSA INDIAN HEALTH CLINIC",
            "address_2": "PO BOX 1569",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953381569",
            "telephone_number": "209-966-0573",
            "fax_number": "209-742-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARIPOSA INDIAN HEALTH CLINIC",
            "address_2": "5192 HOSPITAL ROAD",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953381569",
            "telephone_number": "209-966-0573",
            "fax_number": "209-742-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "PERRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jim Whitworth, PARAMEDIC
• Carlyn C Wice
• Caleen C Wieg
• Thomas George Wieg, D.D.S.
• Carla R Williams
• Yosemite Dental Care, LLC
• Yosemite Medical Services, Inc.
• Yosemite Valley Medical Services, a Medical Corporation

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.