Active NPI
Laurence Wong, D.D.S.
- General Practice Dentistry
- Palo Alto, CA
National Provider Identifier
1407065683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 25047
- Practice address
- 655 Homer Ave
Palo Alto, CA 94301-2887 - Phone
- (650) 322-6774
- NPI assigned
- May 22, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 25047 | CA | Primary |
Addresses
Primary practice location
655 Homer Ave
Palo Alto, CA 94301-2887
Mailing address
655 Homer Ave
Palo Alto, CA 94301-2887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1223G0001X | Other | CA | GENERAL PRACTICE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407065683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 HOMER AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943012887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 HOMER AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943012887",
"telephone_number": "650-322-6774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "LAURENCE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "25047",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GENERAL PRACTICE",
"identifier": "1223G0001X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.