Lyndon Daizo Fong, LYNDON FONG DDS MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

1441 Issued in HI

Practice address

1441 Kapiolani Blvd Ste 616
Suite 616
Honolulu, HI 96814-4403

Phone

(808) 947-3333

Fax

(808) 947-3381

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 1

Other names 1

• Dr. Lyndon Daizo Fong Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lyndon D. Fong DDS Ms

  • Periodontics
  • Honolulu, HI
  • NPI 1932337961
  NPD (past) Authorized official

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578614558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD STE 616",
            "address_2": "SUITE 616",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144403",
            "telephone_number": "808-947-3333",
            "fax_number": "808-947-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD STE 616",
            "address_2": "SUITE 616",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144403",
            "telephone_number": "808-947-3333",
            "fax_number": "808-947-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "LYNDON",
        "middle_name": "DAIZO",
        "name_prefix": "Dr.",
        "credential": "LYNDON FONG DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "HI",
            "license": "1441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HI ST. DENTAL LIC. #",
            "identifier": "1441",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDON",
            "last_name": "FONG",
            "middle_name": "DAIZO",
            "prefix": "DR.",
            "credential": "LYNDON FONG DDS MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Henry Hung Chong Fong, M.D.
• Jackson Z Fong, PHARM.D
• Linda Luchau Fong, LCSW
• Lisa Fong
• Lori Fong
• Phyllis B Y Fong, PT
• Rodney S.O. Fong, O.D.
• Taylor Fong, OTD, OTR/L
• William Fong, MD
• Sharee Fonoti

• Periodontics in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Periodontics in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.