Nicky Andrew Fong, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DS0000008438 Issued in TN

Practice address

831 Timber Creek Dr
Suite 1
Cordova, TN 38018-3108

Phone

(901) 754-8080

NPI assigned

Apr 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Nick Andrew Fong Professional name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• David W. Smith, DDS PLLC

  • General Practice Dentistry
  • Cordova, TN
  • NPI 1669811634
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336260801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 HUNTERS BLUFF DR",
            "address_2": "APT. 202",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204484",
            "telephone_number": "901-605-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 TIMBER CREEK DR",
            "address_2": "SUITE 1",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380183108",
            "telephone_number": "901-754-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "NICKY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS0000008438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICK",
            "last_name": "FONG",
            "middle_name": "ANDREW",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Victoria Brooks Fisher, OT
• Sandra K Fletchall, OTRL,CHT,FAOTA,MPA
• Sidney Truman Fletcher, DDS
• Gradnette Fluker, LMSW
• Brandy Je'Vonne Flynn, M.S.
• Debra Forbes
• Darius Ford
• Rachel Forrest
• Tekita Vonshia Forrest, M.S
• Katherine N Forsdick, DNP

• Dentist in Cordova, TN
• Providers in Cordova, TN by specialty
• Dentist in Tennessee

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.