Jason Wong, DDS

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

9559 Issued in AZ

Practice address

3101 W Indian School Rd
Phoenix, AZ 85017-4035

Phone

(602) 861-3333

NPI assigned

May 8, 2013

Reactivated

Nov 18, 2016

Last updated

Oct 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696118400000",
    "number": "1942645528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 N 75TH ST UNIT 6008",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852514080",
            "telephone_number": "347-768-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850174035",
            "telephone_number": "602-861-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "695 E. Cottonwood Lane",
            "address_purpose": "LOCATION",
            "city": "Casa Corando",
            "state": "AZ",
            "postal_code": "85122",
            "country_code": "US",
            "telephone_number": "520-876-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "695 E Cottonwood Ln",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851222023",
            "country_code": "US",
            "telephone_number": "520-876-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "JASON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2023-10-01",
        "certification_date": "2023-10-01",
        "deactivation_date": "2014-03-27",
        "reactivation_date": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057530",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "9559",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "AZ",
            "license": "9559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Wong, DO
• Debra A Wong, M.D.
• Gordon Wong
• Gunther Wong, MD
• Janelle Wong, DPT
• Jessica Wong
• Johnson Wong
• Judy Y Wong
• Justin Carmine Wong, M.D.
• Karen K. Wong, M.D.

• Dental Anesthesiology in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dental Anesthesiology in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2023; 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.