NPIMap

Organization Active NPI

David H. Wong, DDS, PC

Doing business as Route 66 Dental Implants & Periodontics

  • Periodontics
  • Tulsa, OK
National Provider Identifier
1790354447
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
DAVID H. WONG, DDS, PC
Doing business as
Route 66 Dental Implants & Periodontics
Practice address
4545 S Harvard Ave
Tulsa, OK 74135-2905
Phone
(918) 749-1850
Fax
(918) 749-2924
NPI assigned
Jun 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Faith Gaskins
Title
Director of Credentialing
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

4545 S Harvard Ave
Tulsa, OK 74135-2905

Mailing address

4545 S Harvard Ave
Tulsa, OK 74135-2905
Phone (918) 749-1850

Other names 1

  • Route 66 Dental Implants & Periodontics Doing business as

National Provider Directory

National Provider Directory

Locations

4545 S Harvard Ave
Tulsa, OK 74135
Phone (918) 749-1850

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1790354447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352905",
            "telephone_number": "918-749-1850",
            "fax_number": "918-749-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352905",
            "telephone_number": "918-749-1850",
            "fax_number": "918-749-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID H. WONG, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Route 66 Dental Implants & Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.