Active NPI
Brian Robert Kong, D.D.S.
- General Practice Dentistry
- San Jose, CA
National Provider Identifier
1235262973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 53813
- Practice address
- 792 Meridian Way
San Jose, CA 95126-3879 - Phone
- (408) 264-1234
- Fax
- (408) 264-1712
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 53813 | CA | Primary |
Addresses
Primary practice location
792 Meridian Way
San Jose, CA 95126-3879
Mailing address
1620 Westwood Dr
Suite a
San Jose, CA 95125-5114
Phone (408) 264-3911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160510002209 | CA | Order and Referring Only - Dentist | 0244529519 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756166400000",
"number": "1235262973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 WESTWOOD DR",
"address_2": "SUITE A",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951255114",
"telephone_number": "408-264-3911",
"fax_number": "408-264-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "792 MERIDIAN WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951263879",
"telephone_number": "408-264-1234",
"fax_number": "408-264-1712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONG",
"first_name": "BRIAN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2025-08-26",
"certification_date": "2025-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "53813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.