NPIMap

Organization Active NPI

Simon Wong DDS Inc

  • Dental Clinic/Center
  • Glendale, CA
National Provider Identifier
1366064859
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SIMON WONG DDS INC
Doing business as
simon wong dds inc
Practice address
1111 N Brand Blvd Ste B
Glendale, CA 91202-3072
Phone
(818) 246-4068
NPI assigned
May 7, 2020
Last updated
May 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Authorized official

Name
Dr. Simon Wong, DDSNPI 1740245646
Title
President
Phone
(626) 354-9667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1111 N Brand Blvd Ste B
Glendale, CA 91202-3072

Mailing address

1111 N Brand Blvd Ste B
Glendale, CA 91202-3072
Phone (818) 246-4068

Other names 1

  • simon wong dds inc 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": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1366064859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N BRAND BLVD STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023072",
            "telephone_number": "818-246-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N BRAND BLVD STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023072",
            "telephone_number": "818-246-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMON WONG DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-354-9667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "simon wong dds inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.