Agnes Gan Ong, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49383 Issued in CA

Practice address

655 S Central Valley Hwy
Shafter, CA 93263-2790

Phone

(661) 746-9194

Fax

(661) 459-1974

NPI assigned

Jun 9, 2005

Last updated

Jan 24, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agnes.ong.p1@direct.omnifamilyhealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Buttonwillow, CA
  • NPI 1700891660

  General Practice

  Medicare reassignment NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Shafter, CA
  • NPI 1366463085

  General Practice

  NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1770399669
  NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Lost Hills, CA
  • NPI 1376558221

  General Practice

  NPD (past)
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Wasco, CA
  • NPI 1689688004
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1700880622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 S CENTRAL VALLEY HWY",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632790",
            "telephone_number": "661-459-1900",
            "fax_number": "661-459-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S CENTRAL VALLEY HWY",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632790",
            "telephone_number": "661-746-9194",
            "fax_number": "661-459-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG",
        "first_name": "AGNES",
        "middle_name": "GAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omni Family Health
• Omni Family Health
• Omni Family Health
• Omni Family Health
• Omni Family Health
• Mia Valerie Ortiz
• Chan H. Park, M.D.
• Olivia Jin-Young Park, D.D.S.
• Parrott Gordon & Associates L.P. (Adept Dental Group Shafter)
• Bhadraksh P Patel

• General Practice Dentistry in Shafter, CA
• Providers in Shafter, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.