Dr. Stephanie ML Wong DMD Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DT-1605 Issued in HI

Legal business name

DR. STEPHANIE ML WONG DMD INC

Practice address

4211 Waialae Ave Ste 204
Honolulu, HI 96816-5312

Phone

(808) 732-3072

Fax

(808) 732-0779

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie ML Wong, DMDNPI 1861625964

Title

President

Phone

(808) 732-3072

Specialties & licenses 1

Addresses

Other names 1

• HAWAIIAN DENTAL ASSOCIATES Doing business as

Locations

Practitioners 1

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

• Stephanie ML Wong, DMD

  • General Practice Dentistry
  • Honolulu, HI
  • NPI 1861625964
  NPD (past) Authorized official

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669516258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 WAIALAE AVE STE 204",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165312",
            "telephone_number": "808-732-3072",
            "fax_number": "808-732-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 WAIALAE AVE STE 204",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165312",
            "telephone_number": "808-732-3072",
            "fax_number": "808-732-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. STEPHANIE ML WONG DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ML",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-732-3072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-1605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAWAIIAN DENTAL ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Honolulu, HI
• Providers in Honolulu, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.