NPIMap

Organization Active NPI

Stephen Y. Pong, D.D.S., P.L.L.C.

  • General Practice Dentistry
  • Federal Way, WA
National Provider Identifier
1902130560
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
602955173 Issued in WA
Legal business name
STEPHEN Y. PONG, D.D.S., P.L.L.C.
Practice address
2122 SW 336TH St
Federal Way, WA 98023-2883
Phone
(253) 927-7777
Fax
(253) 927-6319
NPI assigned
Sep 29, 2009
Last updated
Sep 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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

Authorized official

Name
Dr. Stephen Y. Pong, D.D.S.NPI 1174650253
Title
General Dentist/ Owner
Phone
(253) 927-7777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 602955173 WA Primary

Addresses

Primary practice location

2122 SW 336TH St
Federal Way, WA 98023-2883

Mailing address

2122 SW 336TH St
Federal Way, WA 98023-2883
Phone (253) 927-7777

National Provider Directory

National Provider Directory

Locations

2122 SW 336th St
Federal Way, WA 98023
Phone (253) 927-7777

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254182400000",
    "number": "1902130560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 SW 336TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232883",
            "telephone_number": "253-927-7777",
            "fax_number": "253-927-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 SW 336TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232883",
            "telephone_number": "253-927-7777",
            "fax_number": "253-927-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN Y. PONG, D.D.S., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A",
        "authorized_official_last_name": "PONG",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "GENERAL DENTIST/ OWNER",
        "authorized_official_telephone_number": "253-927-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "602955173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; 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.