Active NPI
Sarah Nicole Wong, DDS
- General Practice Dentistry
- Pontiac, MI
National Provider Identifier
1972120335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2951000817
- Practice address
- 44405 Woodward Avenue
Medical Education - H23
Pontiac, MI 48341 - Phone
- (313) 917-3391
- NPI assigned
- Jul 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2951000817 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Avenue
Medical Education - H23
Pontiac, MI 48341
Mailing address
44405 Woodward Avenue
Medical Education - H23
Pontiac, MI 48341
Phone (313) 917-3391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200805002814 | MI | Order and Referring Only - Dentist | 5496170623 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1972120335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVENUE",
"address_2": "MEDICAL EDUCATION - H23",
"city": "PONTIAC",
"state": "MI",
"postal_code": "48341",
"telephone_number": "313-917-3391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVENUE",
"address_2": "MEDICAL EDUCATION - H23",
"city": "PONTIAC",
"state": "MI",
"postal_code": "48341",
"telephone_number": "313-917-3391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "SARAH",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-01",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2951000817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.