MEDICARE: RICHARD ONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN30485	FL

General Provider Information

NPI Number	:	1629879523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ONG

Provider Business Mailing Address
First Line	:	2102 OAK LEAF CIR
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-9679
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7651 SW STATE ROAD 200
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34476-7726
Country	:	US
Telephone Number	:	352-854-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	06/17/2025

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Directions to “ RICHARD ONG ” Practice Location

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