Simon Wong Dental Group Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SIMON WONG DENTAL GROUP INC.

Practice address

927 E Garvey Ave
Monterey Park, CA 91755-3028

Phone

(626) 255-1010

NPI assigned

May 7, 2020

Organization subpart

No

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

Authorized official

Name

Simon Wong, DDSNPI 1740245646

Title

President

Phone

(626) 354-9667

Specialties & licenses 1

Addresses

Other names 2

• Calstate Dental Doing business as
• Calstate Dental Inc 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.

• Simon Wong, D.D.S.

  • General Practice Dentistry
  • Glendale, CA
  • NPI 1740245646
  NPD (past) Authorized official

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1689296105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 E GARVEY AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917553028",
            "telephone_number": "626-255-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 E GARVEY AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917553028",
            "telephone_number": "626-255-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMON WONG DENTAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-354-9667",
        "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": "Calstate Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Calstate Dental Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cindy Xinchun Shu, MD
• Sirivanh Kongbouakhay Shuffer, L.C.S.W.
• Heather Siu Shum
• Rebecca Ermenia Silva, PA-C
• Kenneth T Sim, MD
• Kennedy Singer
• Singh a. Boun, MD & Nick Lee, MD, a Professional Corporation
• Reuven Fernandez Sison, M.D.
• Jacinta Nyssa Situ, RPH
• Natalya Sivashov, LMFT

• Dental Clinic/Center in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.