Wong Family Dental Center, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN0011013 Issued in FL

Legal business name

WONG FAMILY DENTAL CENTER, PA

Practice address

330 S Lake Shore Way
Lake Alfred, FL 33850-2750

Phone

(863) 956-2700

Fax

(863) 956-2770

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Anthony Ignatius Wong, DDSNPI 1306850037

Title

Owner

Phone

(863) 956-2700

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony Ignatius Wong, DDS

  • General Practice Dentistry
  • Lake Alfred, FL
  • NPI 1306850037
  NPD (past) Authorized official
• Carol Wong, DDS

  • Public Health Dentistry
  • Lake Alfred, FL
  • NPI 1437298973
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1336153337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S LAKE SHORE WAY",
            "city": "LAKE ALFRED",
            "state": "FL",
            "postal_code": "338502750",
            "telephone_number": "863-956-2700",
            "fax_number": "863-956-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S LAKE SHORE WAY",
            "city": "LAKE ALFRED",
            "state": "FL",
            "postal_code": "338502750",
            "telephone_number": "863-956-2700",
            "fax_number": "863-956-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONG FAMILY DENTAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "IGNATIUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-956-2700",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0011013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatianna Rivera Pagan
• Zeena Satar, MSN, FNP-C
• Regina Solomon
• Southern Gardens FL Al Management LLC (The Gardens of Lake Alfred)
• Southern Gardens, LLC
• Anthony Ignatius Wong, DDS
• Carol Wong, DDS
• Tara Woodward, PTA
• Breanna Wortelman
• Yanelis Del Rocio Zayas Bacallao

• General Practice Dentistry in Lake Alfred, FL
• Providers in Lake Alfred, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.