Jennifer Fong, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22DI02869600 Issued in NJ

Practice address

66 Somme St
Newark, NJ 07105-3612

Phone

(973) 288-2723

NPI assigned

Nov 27, 2021

Last updated

Nov 27, 2021By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637971200000",
    "number": "1376200204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 PATERSON AVE # 206",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731339",
            "telephone_number": "916-607-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SOMME ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071053612",
            "telephone_number": "973-288-2723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Railroad Plz Ste 2",
            "address_purpose": "LOCATION",
            "city": "Whippany",
            "state": "NJ",
            "postal_code": "079811548",
            "country_code": "US",
            "telephone_number": "973-288-2723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501B Springfield Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley Heights",
            "state": "NJ",
            "postal_code": "079221180",
            "country_code": "US",
            "telephone_number": "973-288-2723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1124 E Jersey St",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072012406",
            "country_code": "US",
            "telephone_number": "973-288-2723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509A Orange St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071072128",
            "country_code": "US",
            "telephone_number": "973-288-2723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONG",
        "first_name": "JENNIFER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-27",
        "last_updated": "2021-11-27",
        "certification_date": "2021-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02869600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Newark, NJ
• Providers in Newark, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.