NPIMap

Organization Active NPI

Betty J. Fong DDS, a Professional Corporation

Doing business as North Shore Dental

  • Dentist
  • Hercules, CA
National Provider Identifier
1285776336
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BETTY J. FONG DDS, A PROFESSIONAL CORPORATION
Doing business as
North Shore Dental
Practice address
500 Alfred Nobel Dr
Suite 240
Hercules, CA 94547-1838
Phone
(510) 741-2140
NPI assigned
Feb 13, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Betty Fong, D.D.S.
Title
Dentist
Phone
(510) 741-2140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X CA Primary

Addresses

Primary practice location

500 Alfred Nobel Dr
Suite 240
Hercules, CA 94547-1838

Mailing address

500 Alfred Nobel Dr
Suite 240
Hercules, CA 94547-1838
Phone (510) 741-2140

Other names 1

  • North Shore Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285776336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALFRED NOBEL DR",
            "address_2": "SUITE 240",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471838",
            "telephone_number": "510-741-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALFRED NOBEL DR",
            "address_2": "SUITE 240",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471838",
            "telephone_number": "510-741-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTY J. FONG DDS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "510-741-2140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hercules, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.