NPIMap

Organization Active NPI

Tim Wong DDS Dental Corporation

  • Dentist
  • Monterey Park, CA
National Provider Identifier
1508629502
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TIM WONG DDS DENTAL CORPORATION
Practice address
210 S Garfield Ave
Monterey Park, CA 91754-2904
Phone
(626) 280-2113
Fax
(626) 280-3798
NPI assigned
Feb 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Dr. Timothy Wong, DDSNPI 1871077750
Title
President
Phone
(323) 350-6383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

210 S Garfield Ave
Monterey Park, CA 91754-2904

Mailing address

210 S Garfield Ave
Monterey Park, CA 91754-2904
Phone (626) 280-2113

National Provider Directory

National Provider Directory

Locations

210 S Garfield Ave
Monterey Park, CA 91754
Phone (626) 280-2113

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1508629502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GARFIELD AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917542904",
            "telephone_number": "626-280-2113",
            "fax_number": "626-280-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GARFIELD AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917542904",
            "telephone_number": "626-280-2113",
            "fax_number": "626-280-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM WONG DDS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-350-6383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.