Eric Thomas Wong, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

58395 Issued in CA

Practice address

23326 Hawthorne Blvd
Suite 310
Torrance, CA 90505-3725

Phone

(310) 378-4220

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Eric T. Wong D.D.S., a Professional Corp

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Torrance, CA
  • NPI 1811214356
  NPD (past) Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1508071358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23326 HAWTHORNE BLVD.",
            "address_2": "SUITE 310",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053725",
            "telephone_number": "310-378-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23326 HAWTHORNE BLVD",
            "address_2": "SUITE 310",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053725",
            "telephone_number": "310-378-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ERIC",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "58395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508071358",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Wong
• Brian Keith Wong, MD
• Carrie Ka Lei Wong, D.D.S
• Curtice Wong, MD
• David Yen Man Wong, M.D.
• Jacob Kristofer Alba Wong
• John Wong, MD
• Johnny Wong, MD
• Krista Wong, OD
• Lulu Lu Wong, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Torrance, CA
• Providers in Torrance, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.