NPIMap

Organization Active NPI

Wong Blue Ocean Dental Office PC

  • Dental Clinic/Center
  • Glendora, CA
National Provider Identifier
1659896462
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
WONG BLUE OCEAN DENTAL OFFICE PC
Doing business as
Wong Blue Ocean Dental Office PC
Practice address
408 W Baseline Rd
Glendora, CA 91740-4801
Phone
(626) 852-6999
Fax
(626) 852-6909
NPI assigned
Aug 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Fred C Wong, DDSNPI 1447372354
Title
Dentist
Phone
(626) 852-6999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

408 W Baseline Rd
Glendora, CA 91740-4801

Mailing address

408 W Baseline Rd
Glendora, CA 91740-4801
Phone (626) 852-6999

Other names 1

  • Wong Blue Ocean Dental Office PC Doing business as

National Provider Directory

National Provider Directory

Locations

408 W Baseline Rd
Glendora, CA 91740
Phone (626) 852-6999

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659896462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W BASELINE RD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404801",
            "telephone_number": "626-852-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W BASELINE RD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404801",
            "telephone_number": "626-852-6999",
            "fax_number": "626-852-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONG BLUE OCEAN DENTAL OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "626-852-6999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wong Blue Ocean Dental Office PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.