Teresina N Wong, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38624 Issued in CA

Practice address

2008 Columbus Pkwy
Benicia, CA 94510-5400

Phone

(707) 745-3838

Fax

(707) 745-3847

NPI assigned

Sep 20, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 12, 2015 through Dec 12, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962509836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 CASTLE ROCK RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985110",
            "telephone_number": "925-938-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 COLUMBUS PKWY",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945105400",
            "telephone_number": "707-745-3838",
            "fax_number": "707-745-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TERESINA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty D Wilson, LMFT
• Gary Allyn Winston, MD
• Hollie Witt, MA, LMFT
• Wong & Barretto Dental Inc
• Michelle B Wong, D.D.S.
• Woodbridge Transitions, LLC.
• David Woodin, LMFT
• Anny Wu
• Yan Kalika Dental Corporation
• Aaron Joseph Zaks, DO

• General Practice Dentistry in Benicia, CA
• Providers in Benicia, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.