Individual provider Active NPI

Andrew Ying Cheung Tong, DMD

  • Pediatric Dentistry
  • Davis, CA
National Provider Identifier
1194934695
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D54980 Issued in CA
Practice address
2051 John Jones Rd
Davis, CA 95616-9701
Phone
(530) 757-4667
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D54980 CA Primary

Addresses

Primary practice location

2051 John Jones Rd
Davis, CA 95616-9701

Mailing address

206 Aster St
Vacaville, CA 95688-8881
Phone (213) 364-1818

Other practice location 1

500 Jefferson Blvd
West Sacramento, CA 95605-2350
Phone (916) 403-2960

Other practice location 2

619 Lincoln Ave
Woodland, CA 95695-4017
Phone (530) 297-8614

Other identifiers 1

IdentifierTypeStateIssuer
D54980OtherCASTATE LICENSE

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
D54980CAMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: atong676109@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1194934695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 ASTER ST",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956888881",
            "telephone_number": "213-364-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 JOHN JONES RD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956169701",
            "telephone_number": "530-757-4667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "West Sacramento",
            "state": "CA",
            "postal_code": "956052350",
            "country_code": "US",
            "telephone_number": "916-403-2960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "CA",
            "postal_code": "956954017",
            "country_code": "US",
            "telephone_number": "530-297-8614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TONG",
        "first_name": "ANDREW",
        "middle_name": "YING CHEUNG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "D54980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "D54980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.