NPIMap

Organization Active NPI

D.Wong, DDS, Dental Corporation

  • Dentist
  • San Mateo, CA
National Provider Identifier
1174983779
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59808 Issued in CA
Legal business name
D.WONG, DDS, DENTAL CORPORATION
Practice address
255 N San Mateo Dr
Suite #2
San Mateo, CA 94401-2655
Phone
(650) 347-7100
NPI assigned
Feb 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Authorized official

Name
Dr. Derek WongNPI 1427367135
Title
President
Phone
(650) 347-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 59808 CA Primary

Addresses

Primary practice location

255 N San Mateo Dr
Suite #2
San Mateo, CA 94401-2655

Mailing address

255 N San Mateo Dr
Suite #2
San Mateo, CA 94401-2655
Phone (650) 347-7100

National Provider Directory

National Provider Directory

Locations

255 N San Mateo Dr
Ste 2
San Mateo, CA 94401
Phone (650) 347-7100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456358400000",
    "number": "1174983779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N SAN MATEO DR",
            "address_2": "SUITE #2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012655",
            "telephone_number": "650-347-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N SAN MATEO DR",
            "address_2": "SUITE #2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012655",
            "telephone_number": "650-347-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.WONG, DDS, DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-02-25",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-347-7100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "59808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.