Individual provider Active NPI

Hoi Sze Wong, DDS

  • Periodontics
  • Chula Vista, CA
National Provider Identifier
1720059702
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
55490 Issued in CA
Practice address
450 4TH Ave Ste 409
Chula Vista, CA 91910-4430
Phone
(619) 425-1800
Fax
(619) 425-1802
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 55490 CA Primary

Addresses

Primary practice location

450 4TH Ave Ste 409
Chula Vista, CA 91910-4430

Mailing address

450 4TH Ave Ste 409
Chula Vista, CA 91910-4430
Phone (619) 425-1800

Other identifiers 1

IdentifierTypeStateIssuer
1720059702OtherNOT AFFILIATED WITH MEDICARE

Other names 1

  • Dr. Hoi Sze Wong Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160226001384 CA Order and Referring Only - DentistPractitioner - Dentist 2163727215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1720059702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 4TH AVE STE 409",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104430",
            "telephone_number": "619-425-1800",
            "fax_number": "619-425-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 4TH AVE STE 409",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104430",
            "telephone_number": "619-425-1800",
            "fax_number": "619-425-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "HOI SZE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "55490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT AFFILIATED WITH MEDICARE",
            "identifier": "1720059702",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOI SZE",
            "last_name": "WONG",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.