Angelica Pamela Wong, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

54667 Issued in CA

Practice address

151 S Mednik Ave
Los Angeles, CA 90022-1606

Phone

(323) 263-3303

Fax

(323) 263-3341

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Southern Charm Pediatric Dentistry

  • Pediatric Dentistry
  • Indian Land, SC
  • NPI 1073162053
  NPD (past) Authorized official
• Michelle to, DDS Inc

  • Pediatric Dentistry
  • East Los Angeles, CA
  • NPI 1972528958
  NPD (past)
• Tan, DDS and Tran, DDS, Inc

  • Pediatric Dentistry
  • Los Angeles, CA
  • NPI 1407191810
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609920529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7811 BAYSINGER ST",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902412224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S MEDNIK AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221606",
            "telephone_number": "323-263-3303",
            "fax_number": "323-263-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ANGELICA",
        "middle_name": "PAMELA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "54667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "54667",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Wong, PHARMD
• Albert Wong, M.D.
• Andrea Wong, O.D.
• Andrea Keak Wong, CRNA
• Angela V. Wong, MD
• Angie Wong, LMT
• Ann R Wong
• Anna Wong, FNP
• Anna Mei Ting Wong, OTR
• Arthur H. Wong, MD

• Pediatric Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Dentistry in California

• 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.