Michelle M Fong

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106467 Issued in CA

Practice address

155 Birch St Ste 5
Redwood City, CA 94062-1340

Phone

(650) 366-0552

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Birch Dental Group

  • General Practice Dentistry
  • Redwood City, CA
  • NPI 1508052382
  NPD (past)
• Pacific Dental Group

  • General Practice Dentistry
  • San Rafael, CA
  • NPI 1669802435
  NPD (past)

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1376114702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 28TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941223231",
            "telephone_number": "415-683-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BIRCH ST STE 5",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621340",
            "telephone_number": "650-366-0552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N San Mateo Dr Unit A",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944012417",
            "country_code": "US",
            "telephone_number": "650-344-7626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1523 5th Ave",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949011806",
            "country_code": "US",
            "telephone_number": "415-453-6277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONG",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Beck Flynn
• Marilyn Jane Foley, PH.D.
• Brian William Fong, D.M.D.
• Kimberly Ann Fong, RDHAP
• Michelle Josephine Fong
• Ronald Leigh Fong, MD
• Emmanuel Yves Fonlupt
• Kyna Forbus, LMT
• Forever Young Assisted Living, Inc.
• Jennifer Forman, PH.D

• General Practice Dentistry in Redwood City, CA
• Providers in Redwood City, 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 Aug 2, 2021; 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.