Shan Gong, D.M.D.

Primary specialty

Orofacial Pain DentistryTaxonomy code 1223X2210X

License

101693 Issued in CA

Practice address

8413 N Millbrook Ave Ste 101
Fresno, CA 93720-2195

Phone

(559) 448-9000

NPI assigned

Feb 29, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shan Gong DMD Ms Inc

  • Orofacial Pain Dentistry
  • Fresno, CA
  • NPI 1558194928
  NPD Authorized official

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1912367269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8413 N MILLBROOK AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202195",
            "telephone_number": "559-448-9000",
            "fax_number": "559-449-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8413 N MILLBROOK AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202195",
            "telephone_number": "559-448-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "SHAN",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "101693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Dow Gong
• Madeline T. Gong, MD
• Marshal F Gong, D.C.
• Matthew Sien Jow Gong
• Roger J Gong, MD
• Ashley Gongora, RN
• Anaisa Marie Gonzales
• Andrew Gonzales
• April Frances Gonzales
• April R Gonzales I

• Orofacial Pain Dentistry in Fresno, CA
• Providers in Fresno, CA by specialty
• Orofacial Pain Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.

Verify at the official NPI Registry.