Jason Gilbert Wong, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

52132 Issued in CA

Practice address

721 W Whittier Blvd Ste B
La Habra, CA 90631-3771

Phone

(310) 463-4762

NPI assigned

May 22, 2007

Last updated

Aug 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1750590014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W WHITTIER BLVD",
            "address_2": "STE B",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313771",
            "telephone_number": "310-463-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W WHITTIER BLVD STE B",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313771",
            "telephone_number": "310-463-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JASON",
        "middle_name": "GILBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "52132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitten Heights Assisted Living and Memory Care
• Whitten LLC
• Bianca A Williams
• Jenelle Winley
• Ayisha Lesha Winn, LCSW
• Kevin Woo, OMD
• Blair Worrall, M.S., CCC
• Tammy Xie, PHARMD
• Carla Yaldezian, MS, RD
• Alice Wan-Ching Yang, DDS

• Endodontics in La Habra, CA
• Providers in La Habra, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.