Individual provider Active NPI

Norman Wong, DDS

  • General Practice Dentistry
  • Pleasanton, CA
National Provider Identifier
1194804625
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37042 Issued in CA
Practice address
5720 Stoneridge Mall Rd Ste 295
Pleasanton, CA 94588-2830
Phone
(925) 846-5506
Fax
(925) 846-5675
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 37042 CA Primary

Addresses

Primary practice location

5720 Stoneridge Mall Rd Ste 295
Pleasanton, CA 94588-2830

Mailing address

5720 Stoneridge Mall Rd Ste 295
Pleasanton, CA 94588-2830
Phone (925) 846-5506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37042CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1194804625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 STONERIDGE MALL RD STE 295",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882830",
            "telephone_number": "925-846-5506",
            "fax_number": "925-846-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 STONERIDGE MALL RD STE 295",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882830",
            "telephone_number": "925-846-5506",
            "fax_number": "925-846-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "NORMAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.