Active NPI
Carol Wong, DDS
- Public Health Dentistry
- Lake Alfred, FL
National Provider Identifier
1437298973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- DN14802
- Practice address
- 330 S Lake Shore Way
Lake Alfred, FL 33850-2750 - Phone
- (863) 956-2700
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | DN14802 | FL | Primary |
Addresses
Primary practice location
330 S Lake Shore Way
Lake Alfred, FL 33850-2750
Mailing address
330 S Lake Shore Way
Lake Alfred, FL 33850-2750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 075405600 | Medicaid | FL |
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 |
|---|---|---|---|
| DN14802 | FL | MD | Public Health Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wong Family Dental Center, PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Lake Alfred, FL
- NPI 1336153337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367020800000",
"number": "1437298973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 S LAKE SHORE WAY",
"city": "LAKE ALFRED",
"state": "FL",
"postal_code": "338502750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 S LAKE SHORE WAY",
"city": "LAKE ALFRED",
"state": "FL",
"postal_code": "338502750",
"telephone_number": "863-956-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "CAROL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2013-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "FL",
"license": "DN14802",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "075405600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Alfred, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.