Leslie Mark Wong, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33879 Issued in CA

Practice address

827 Blossom Hill Rd
Suite W-3
San Jose, CA 95123-2701

Phone

(408) 224-2000

Fax

(408) 224-4111

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Les M Wong Other name

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

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154464790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 BLOSSOM HILL RD",
            "address_2": "SUITE W-3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232701",
            "telephone_number": "408-224-2000",
            "fax_number": "408-224-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 BLOSSOM HILL RD",
            "address_2": "SUITE W-3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232701",
            "telephone_number": "408-224-2000",
            "fax_number": "408-224-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LESLIE",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LES",
            "last_name": "WONG",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karen Anita Wong, SLP
• Kate Wong
• Kenneth Wong, MD
• Kenneth Wong
• Kindchia Wong
• Li Shao Wong
• Lianna Wong, OTR/L
• Mandy Wong, DC
• Marilyn Tin Wong, MD
• Matthew Wong, PA-C

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.