Stephen Y Pong, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00010069 Issued in WA

Practice address

780 8TH Ave S. Suite 100
Seattle, WA 98104-3033

Phone

(206) 788-3700

Fax

(206) 788-3706

NPI assigned

Feb 27, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: spong1187825@wm.providencedirect.org

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.

• Stephen Y. Pong, D.D.S., P.L.L.C.

  • General Practice Dentistry
  • Federal Way, WA
  • NPI 1902130560
  NPD (past) Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1174650253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24911",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240911",
            "telephone_number": "206-788-3612",
            "fax_number": "206-652-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 8TH AVE S. SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043033",
            "telephone_number": "206-788-3700",
            "fax_number": "206-788-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONG",
        "first_name": "STEPHEN",
        "middle_name": "Y",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skylar Winston Pond, D.C.
• Alexis Echo Pong, PA
• Eric Brandon Pong, MD
• Jessica Pong, PHARM D
• Ryan P Pong, MD
• Lauren Poniatowski, MD, MS
• Tanya Sajan Ponnatt, MD
• Kellan Pontarolo
• Jason Pool
• Sara Frances Pool, SLP-CCC

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.