Nathan Gee Yut Wong, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14553 Issued in MN

Practice address

7200 Hemlock LN N Ste 105
Maple Grove, MN 55369-5587

Phone

(763) 424-4415

NPI assigned

May 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Fu Wong DDS PA

  • Dentist
  • Maple Grove, MN
  • NPI 1750556627
  NPD (past)

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1548834385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 COVEY TRL",
            "city": "MEDINA",
            "state": "MN",
            "postal_code": "553404000",
            "telephone_number": "763-210-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 HEMLOCK LN N STE 105",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695587",
            "telephone_number": "763-424-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "NATHAN",
        "middle_name": "GEE YUT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Wolfgramm
• Claire Wolters
• Ashley Wong, AU.D.
• Fu Wong, DDS
• Jonathan Gee Hin Wong
• Stacy Adair Woodard
• Barbara Wormington
• Angel Wright
• Susan Mentjes Wrobel, NP
• Lucas Walker Wyatt, LPCC

• Dentist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Dentist in Minnesota

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