Samantha Wong, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS035011 Issued in PA

Practice address

108 Dekalb St
Bridgeport, PA 19405-1017

Phone

(610) 278-0009

Fax

(610) 278-0893

NPI assigned

Mar 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SBW Dental Associates, P.C.

  dba King of Prussia Family

  • Public Health Dentistry
  • King of Prussia, PA
  • NPI 1073195426
  NPD (past) Authorized official

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447229794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CAMELOT DR",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622103",
            "telephone_number": "610-278-0009",
            "fax_number": "610-278-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 DEKALB ST",
            "city": "BRIDGEPORT",
            "state": "PA",
            "postal_code": "194051017",
            "telephone_number": "610-278-0009",
            "fax_number": "610-278-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA NUMBER",
            "identifier": "1511312",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Riley, MS
• Dana J Schaeffer-Cherashore, RPH
• Caleb William Schultz, MS, OTR/L
• Eric Anthony Sibilla, DPT
• Nathalie Wilson, MPT
• Workers First Clinical Services LLC
• Workers First Pharmacy Services LLC (Synergy Pharmacy)
• Lisa Young, CSW

• General Practice Dentistry in Bridgeport, PA
• Providers in Bridgeport, PA by specialty
• General Practice Dentistry in Pennsylvania

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.