Joel A Fong

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS104341 Issued in CA

Practice address

1350 E Main St
Grass Valley, CA 95945-5208

Phone

(530) 477-8545

NPI assigned

Apr 28, 2018

Last updated

Jun 9, 2021By the provider in NPPES

Sex

Male

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

Enrolled in CA

Eligible to order & refer

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

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.

• River City Dental Group

  • General Practice Dentistry
  • Fair Oaks, CA
  • NPI 1700276771
  NPD (past)
• Shingle Springs Rancheria

  dba Shingle Springs Health and Wellness Center

  • Health Service Clinic/Center
  • Placerville, CA
  • NPI 1245356674

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1524873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1336637909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 COUNTRY CLUB DR APT 3B",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828546",
            "telephone_number": "510-393-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E MAIN ST",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455208",
            "telephone_number": "530-477-8545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11670 Atwood Rd",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "CA",
            "postal_code": "956039522",
            "country_code": "US",
            "telephone_number": "530-887-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONG",
        "first_name": "JOEL",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-28",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS104341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Scott Fletcher, DDS, DDS
• Lori Flippin
• John Fogleman
• Roy L Foliente, M.D.
• Colleen Foltz
• Foot and Ankle Surgeons of Northern California
• Jennifer Foote
• Jessica Foote
• Foothill House of Hospitality (Hospitality House)
• Foothill House of Hospitality (Hospitality House)

• General Practice Dentistry in Grass Valley, CA
• Providers in Grass Valley, 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 Jun 9, 2021; 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.