Peter Fong, DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40817 Issued in CA

Legal business name

PETER FONG, DDS, INC.

Practice address

1050 Northgate Dr Ste 139
San Rafael, CA 94903-2559

Phone

(415) 472-2770

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Peter Fong

Title

President

Phone

(415) 472-2770

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yevgeniya Valchuk, D.D.S.

  • General Practice Dentistry
  • San Rafael, CA
  • NPI 1780077305
  NPD (past)

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250467200000",
    "number": "1578777918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 NORTHGATE DR STE 139",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032559",
            "telephone_number": "415-472-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NORTHGATE DR STE 139",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032559",
            "telephone_number": "415-472-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER FONG, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2009-08-17",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-472-2770"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David George Perkins
• Will Perkins
• Glenn Alan Perry, PH.D., MFT
• Maria Jose Perry, PSY.D.
• Jayme L Peta, PHD
• Douglas P. Peter-Frank, PSY.D.
• Ashley Harris Petersen, MFT
• Adam F. Petras, MD
• Mallory Petty, M.S. CF-SLP
• Karen J Pfaeffle, M.A.

• General Practice Dentistry in San Rafael, CA
• Providers in San Rafael, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; 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.