Active NPI
Wendy Wong, D.D.S.
- General Practice Dentistry
- Downey, CA
National Provider Identifier
1780086017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 63791
- Practice address
- 9474 Firestone Blvd
Downey, CA 90241-5504 - Phone
- (562) 803-4224
- NPI assigned
- Sep 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 63791 | CA | Primary |
Addresses
Primary practice location
9474 Firestone Blvd
Downey, CA 90241-5504
Mailing address
1417 S Atlantic Blvd
Apt. 24
Alhambra, CA 91803-3168
Phone (213) 545-1858
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150806011684 | CA | Order and Referring Only - Dentist | 6204140056 |
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": "1410998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434931200000",
"number": "1780086017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 S ATLANTIC BLVD",
"address_2": "APT. 24",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918033168",
"telephone_number": "213-545-1858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9474 FIRESTONE BLVD",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902415504",
"telephone_number": "562-803-4224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "WENDY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-18",
"last_updated": "2015-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "63791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.