Mark Alan Wong, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

54788 Issued in CA

Practice address

3075 Citrus Cir Ste 204
Walnut Creek, CA 94598-2667

Phone

(925) 678-5600

Fax

(925) 676-0779

NPI assigned

Jun 13, 2007

Last updated

Oct 1, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: office@markwongdds.com

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1538363437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 CITRUS CIR STE 204",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982667",
            "telephone_number": "925-678-5600",
            "fax_number": "925-676-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 CITRUS CIR STE 204",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982667",
            "telephone_number": "925-678-5600",
            "fax_number": "925-676-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@markwongdds.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "3075 Citrus Cir Ste 204",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945982667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eden Natalie Wong, OTR/L
• Edlen Wong, PHARM.D.
• Joseph David Wong, O.D. , C.R.A.
• Kammie Yiu Wong
• Kenneth Chou Wong, MD
• Mei May Wong
• Oi Lam Wong
• Stacy Lynn Wong, DPT
• Stella Wong
• Stephanie Wong

• Dentist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.