Active NPI
Edward Barnett Wong, DDS
- General Practice Dentistry
- Oakland, CA
National Provider Identifier
1558707406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 62920
- Practice address
- 2220 Mountain Blvd Ste 206
Oakland, CA 94611-2905 - Phone
- (510) 482-5700
- NPI assigned
- May 20, 2013
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 62920 | CA | Primary |
Addresses
Primary practice location
2220 Mountain Blvd Ste 206
Oakland, CA 94611-2905
Mailing address
2316 Cecilia Ave
San Francisco, CA 94116-2508
Phone (909) 896-2149
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 |
|---|---|---|---|
| 62920 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| G Kohli DDS Inc | Current | Accepting new patients | |
| Wonseok Jang Dentistry PLLC | General Practice | Past | Accepting new patients |
| Lily W Eng Oliver, DDS, PLLC | General Practice | Past | Accepting new patients |
Locations
2220 Mountain Blvd
Ste 206
Oakland, CA 94611
Phone (510) 482-5700
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- New York, NY
- NPI 1922143759
-
dba Sunny Dental Care
- Periodontics
- New York, NY
- NPI 1548143902
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760313600000",
"number": "1558707406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2316 CECILIA AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941162508",
"telephone_number": "909-896-2149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2220 MOUNTAIN BLVD STE 206",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946112905",
"telephone_number": "510-482-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "EDWARD",
"middle_name": "BARNETT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-20",
"last_updated": "2025-10-13",
"certification_date": "2025-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "62920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.