Kimberly Ann Fong, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53789 Issued in CA

Practice address

7210 S Land Park Dr Ste E
Sacramento, CA 95831-3663

Phone

(916) 424-0760

Fax

(916) 424-0760

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• KN Fong DDS Dental Conporation

  • Dental Clinic/Center
  • Sacramento, CA
  • NPI 1144824111
  NPD Authorized official
• MJ Fong DDS Dental Corporation

  • Dental Clinic/Center
  • Sacramento, CA
  • NPI 1922602986
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255451944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CINDER CT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958312738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 S LAND PARK DR STE E",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313663",
            "telephone_number": "916-424-0760",
            "fax_number": "916-424-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Fong
• Georgina Ngit Ngo Fong, P. T.
• Grant Russell Fong, DDS
• Jennifer Lee Fong, D.C., L.AC
• Jennifer Lynn Fong, O.D.
• Latisha Antoinette Fong
• Leslie Thomas Fong, D.D.S.
• Lindsay Michelle Fong, D.M.D.
• Makenzie Fong, MS
• Manchiem Sherry Fong

• General Practice Dentistry in Sacramento, CA
• Providers in Sacramento, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.