NPIMap

Organization Active NPI

Rickey & Wong, D.D.S., Inc.

  • General Practice Dentistry
  • Modesto, CA
National Provider Identifier
1235551342
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56244 Issued in CA
Legal business name
RICKEY & WONG, D.D.S., INC.
Practice address
4101 Tully Rd Ste 201
Modesto, CA 95356-8981
Phone
(209) 577-0777
Fax
(209) 577-0885
NPI assigned
Jan 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Authorized official

Name
Robin Walls
Title
Deputy Executive Director
Phone
(209) 577-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 56244 CA Primary

Addresses

Primary practice location

4101 Tully Rd Ste 201
Modesto, CA 95356-8981

Mailing address

4101 Tully Rd Ste 201
Modesto, CA 95356-8981
Phone (209) 577-0777

National Provider Directory

National Provider Directory
Tax ID family
Quality Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4101 Tully Rd
Ste 201
Modesto, CA 95356
Phone (209) 577-0777

Practitioners & affiliated clinicians

Practitioners 3

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": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1235551342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TULLY RD STE 201",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568981",
            "telephone_number": "209-577-0777",
            "fax_number": "209-577-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TULLY RD STE 201",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568981",
            "telephone_number": "209-577-0777",
            "fax_number": "209-577-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICKEY & WONG, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "DEPUTY EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-577-0777"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.