Wilson Wong, DDS, Inc

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

B36856 Issued in CA

Legal business name

WILSON WONG, DDS, INC

Practice address

2340 Irving St
Suite 105
San Francisco, CA 94122-1641

Phone

(415) 753-0333

Fax

(415) 753-1899

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wilson Wong, DDSNPI 1376539429

Title

President/Ceo

Phone

(415) 753-0333

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Wilson Wong, DDS

  • Dentist
  • San Francisco, CA
  • NPI 1376539429
  NPD (past) Authorized official

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1912189226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 IRVING ST",
            "address_2": "SUITE 105",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941221641",
            "telephone_number": "415-753-0333",
            "fax_number": "415-753-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 IRVING ST",
            "address_2": "SUITE 105",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941221641",
            "telephone_number": "415-753-0333",
            "fax_number": "415-753-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON WONG, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "WILSON",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "415-753-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "CA",
            "license": "B36856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G-93552-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bre'Onna Wills
• Jessie Willse
• Melanie Willson
• Amy Rachel Wilner, PSYD
• Sarah Bentley Wilson Hannay, M.D.
• Davon Antoine Wilson-Angel
• Tina Wilson-Avila
• Maureen Summer Wilson-Hwang, N.D.
• Abigail Lee Wilson, M.D.
• Allison Wilson, MD

• Public Health or Welfare Agency in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Public Health or Welfare Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.