Active NPI
Weng Chon Wong, DDS
- Dentist
- Chehalis, WA
National Provider Identifier
1508630484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61464883
- Practice address
- 2690 NE Kresky Ave
Chehalis, WA 98532-2412 - Phone
- (360) 330-9595
- Fax
- (360) 330-9580
- NPI assigned
- Nov 10, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 61464883 | WA | Primary |
Addresses
Primary practice location
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Mailing address
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2269876 | Medicaid | WA |
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 |
|---|---|---|---|
| 61464883 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709078400000",
"number": "1508630484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2690 NE KRESKY AVE",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985322412",
"telephone_number": "360-330-9595",
"fax_number": "360-330-9560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2690 NE KRESKY AVE",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985322412",
"telephone_number": "360-330-9595",
"fax_number": "360-330-9580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "WENG CHON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-10",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "61464883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2269876",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.