NPIMap

Individual provider Active NPI

Lawrence Wong, D.M.D.

  • Dentist
  • Richardson, TX
National Provider Identifier
1629396247
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26315 Issued in TX
Practice address
375 Municipal Dr
Suite 104
Richardson, TX 75080-3559
Phone
(972) 669-3663
NPI assigned
May 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS038253 PA
Dentist 122300000X 26315 TX Primary

Addresses

Primary practice location

375 Municipal Dr
Suite 104
Richardson, TX 75080-3559

Mailing address

7417 Wellcrest Dr
Dallas, TX 75230-4235
Phone (814) 571-3806

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

LicenseStateTypeSpecialty
DS038253PAMDDentist
26315TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Dental Associates, PLLC Past Accepting new patients
Dr Robert E Morgan Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1629396247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7417 WELLCREST DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752304235",
            "telephone_number": "814-571-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MUNICIPAL DR",
            "address_2": "SUITE 104",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803559",
            "telephone_number": "972-669-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-06",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038253",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "26315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.