Michael K Wong, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI 14284 Issued in NJ

Practice address

651 RT. 73 North
Suite 305
Marlton, NJ 08053-3402

Phone

(856) 596-5700

Fax

(856) 596-8157

NPI assigned

Apr 10, 2007

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 1, 2016 through Feb 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1346463148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CLEARBROOK LN",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080803320",
            "telephone_number": "856-906-6409",
            "fax_number": "856-582-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 RT. 73 NORTH",
            "address_2": "SUITE 305",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533402",
            "telephone_number": "856-596-5700",
            "fax_number": "856-596-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI 14284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Wofford, CADC
• Marci Karen Wolfe, OD
• Women for Women Medical Associates
• Allan Wong, DMD
• Gabriel Ho Yu Wong, MD
• Jeffrey Wood, ATC, CSCS
• Sarah R Woods
• Vanessa Woods
• Jeannine Wooley, DMD
• Theodore Wooley, D.M.D

• General Practice Dentistry in Marlton, NJ
• Providers in Marlton, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.