Derek Wong Professional Dental Corporation

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

58157 Issued in CA

Legal business name

DEREK WONG PROFESSIONAL DENTAL CORPORATION

Practice address

430 S Garfield Ave Ste 408
Alhambra, CA 91801-3877

Phone

(626) 284-6626

Fax

(888) 574-6449

NPI assigned

Dec 12, 2014

Last updated

Dec 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Derek Wong, DDSNPI 1245464999

Title

President

Phone

(213) 820-0351

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, and the practitioner matching its NPPES authorized official.

• Derek Wong, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Alhambra, CA
  • NPI 1245464999
  NPD (past) Authorized official

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418342400000",
    "number": "1578961256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S GARFIELD AVE STE 408",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013877",
            "telephone_number": "626-284-6626",
            "fax_number": "888-574-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S GARFIELD AVE STE 408",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013877",
            "telephone_number": "626-284-6626",
            "fax_number": "888-574-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK WONG PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-12",
        "last_updated": "2014-12-12",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-820-0351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "58157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myra Del Rosario
• Andrik Alexander Delgadillo
• Eugene Delrosario, PA
• Stephen P Denq, M.D.
• Derek L Vajda DDS MD Inc
• Harrison Detroy, DDS
• Dhia a M Al-Wardi M D Inc
• Dianne E Wu M D S C a Professional
• Jose Diaz de Leon
• Alma Angelina Diaz

• Orthodontics and Dentofacial Orthopedics Dentistry in Alhambra, CA
• Providers in Alhambra, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.