NPIMap

Organization Active NPI

C F Wong Beta Dental Incorporated

  • Dental Clinic/Center
  • San Luis Obispo, CA
National Provider Identifier
1225527765
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
C F WONG BETA DENTAL INCORPORATED
Practice address
1042 Pacific St Ste B
San Luis Obispo, CA 93401-3661
Phone
(805) 543-6963
Fax
(805) 543-8656
NPI assigned
May 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Christopher F. Wong, DDS
Title
Owner
Phone
(805) 543-6963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1042 Pacific St Ste B
San Luis Obispo, CA 93401-3661

Mailing address

1042 Pacific St Ste B
San Luis Obispo, CA 93401-3661
Phone (805) 543-6963

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Other names 1

  • Magnolia Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1225527765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 PACIFIC ST STE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013661",
            "telephone_number": "805-543-6963",
            "fax_number": "805-543-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 PACIFIC ST STE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013661",
            "telephone_number": "805-543-6963",
            "fax_number": "805-543-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C F WONG BETA DENTAL INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-543-6963",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.