Active NPI
Eric Justin Tong, DDS
- Dentist
- Fort Sam Houston, TX
National Provider Identifier
1821512765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 34980
- Practice address
- 2940 Stanley Rd BLDG 2375
Fort Sam Houston, TX 78234-2740 - Phone
- (210) 295-4156
- NPI assigned
- Aug 2, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10401448-9921 | UT | |
| General Practice Dentistry | 1223G0001X | 34980 | TX | |
| Dentist | 122300000X | 34980 | TX | Primary |
Addresses
Primary practice location
2940 Stanley Rd BLDG 2375
Fort Sam Houston, TX 78234-2740
Mailing address
4070 Stanley Rd BLDG 1029
Fort Sam Houston, TX 78234-2714
Phone (210) 221-0826
Other practice location 1
Germany Bavaria
Unit 28038
Apo, AE 09112
Phone (314) 590-3377
Other practice location 2
200 Arbor Dr Apt J
Columbia, SC 29206-5069
Phone (214) 564-4687
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10401448-9921 | UT | MD | Dentist |
| 34980 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1821512765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4070 STANLEY RD BLDG 1029",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782342714",
"telephone_number": "210-221-0826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 STANLEY RD BLDG 2375",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782342740",
"telephone_number": "210-295-4156"
}
],
"practiceLocations": [
{
"address_1": "GERMANY BAVARIA",
"address_2": "UNIT 28038",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AE",
"postal_code": "09112",
"country_code": "US",
"telephone_number": "314-590-3377",
"country_name": "United States",
"address_type": "MIL"
},
{
"address_1": "200 Arbor Dr Apt J",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292065069",
"country_code": "US",
"telephone_number": "214-564-4687",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TONG",
"first_name": "ERIC",
"middle_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-02",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "10401448-9921",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "34980",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "34980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.