Amy Fong – Dentist in Tecumseh, MI

Key facts

NPI: 1376477257
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 2901602978 (MI)
Practice address: 3085 W Russell Rd
Tecumseh, MI 49286-1735
Phone: (517) 317-6761
NPI assigned: Jun 9, 2026
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	2901602978	MI	Yes

Addresses

Primary practice location

3085 W Russell Rd
Tecumseh, MI 49286-1735

Mailing address

6809 W Poplar St
Boise, ID 83704-7428

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 7, 2026.

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1376477257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 W POPLAR ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 W RUSSELL RD",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861735",
            "telephone_number": "517-317-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tecumseh, MI

All providers in Tecumseh, MI · Dentist in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.