Wallace W. Wong DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

8692WA Issued in WA

Legal business name

WALLACE W. WONG DDS

Practice address

914 140TH Ave NE
Suite 102
Bellevue, WA 98005-3482

Phone

(425) 746-7126

NPI assigned

Jul 19, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wallace W Wong, DDSNPI 1467574335

Title

President

Phone

(425) 746-7126

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wallace Wayne Wong, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bellevue, WA
  • NPI 1467574335
  NPD (past) Authorized official

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1417300062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 140TH AVE NE",
            "address_2": "SUITE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053482",
            "telephone_number": "425-746-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 140TH AVE NE",
            "address_2": "SUITE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053482",
            "telephone_number": "425-746-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE W. WONG DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-746-7126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "8692WA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiegan Walker, LMP
• Jonathan Robert Wall
• Kathy Wall
• Martin J Wall, MD
• Richard Wall, CPO
• Hubert Frederick Wallenfels, AAC
• Jennifer M Waller, LAT, ATC
• Michelle A. a. Waller, MA LMHCA
• Sarah Waller
• Gregory Arthur Wallin

• Orthodontics and Dentofacial Orthopedics Dentistry in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.