Active NPI
Kimberly Ann Fong, RDHAP
- Dental Hygienist
- Redwood City, CA
National Provider Identifier
1396026191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- HAP353
- Practice address
- 876 Boardwalk Place
Redwood City, CA 94065-1809 - Phone
- (415) 640-3274
- Fax
- (650) 593-3327
- NPI assigned
- Sep 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | HAP353 | CA | Primary |
Addresses
Primary practice location
876 Boardwalk Place
Redwood City, CA 94065-1809
Mailing address
PO Box 171
Brisbane, CA 94005-0171
Phone (415) 640-3274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HAP353 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1396026191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 171",
"city": "BRISBANE",
"state": "CA",
"postal_code": "940050171",
"telephone_number": "415-640-3274",
"fax_number": "650-593-3327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "876 BOARDWALK PLACE",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940651809",
"telephone_number": "415-640-3274",
"fax_number": "650-593-3327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "RDHAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-07",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "HAP353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.