King Cheong Brian Wong, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10874 Issued in OR

Practice address

2011 Cedar St
Forest Grove, OR 97116-1701

Phone

(503) 357-5221

NPI assigned

Jul 4, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Brian Wong Other name

Medicare fee-for-service enrollment

Enrolled in OR

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Schuyler Family Dentistry Hubbard PC

  • Dental Clinic/Center
  • Hubbard, OR
  • NPI 1851120208
  NPD (past)

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

{
    "created_epoch": "1499126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1144741737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 NW QUIMBY ST UNIT 304",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092488",
            "telephone_number": "808-728-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 CEDAR ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161701",
            "telephone_number": "503-357-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2838 N Oliver St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672202983",
            "country_code": "US",
            "telephone_number": "316-978-8350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3489 3rd St Ste D",
            "address_purpose": "LOCATION",
            "city": "Hubbard",
            "state": "OR",
            "postal_code": "970329595",
            "country_code": "US",
            "telephone_number": "503-982-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "KING CHEONG",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-04",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61440",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61440",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "WONG",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Noah Wilson-Fey
• Paul Wilson, PT
• Rachael Leeann Wilson, PA-C
• Evan Wollen, O.D.
• Eva Wai-Man Wong
• Eric Brian Woods, L.M.T.
• Jennifer Nicole Wustenberg, RDH
• Nicole Wyman
• Ying Yao, LMT
• Teresa W. Yip, NP (NURSE PRACTITION

• General Practice Dentistry in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.