=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710426226
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAM ONG AND ASSOCIATES DDS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2017
-----------------------------------------------------
Last Update Date | 02/16/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6740 MISSION ST
-----------------------------------------------------
City | DALY CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94014-2031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-991-7397
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6740 MISSION ST
-----------------------------------------------------
City | DALY CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94014-2031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-991-7397
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST OWNER
-----------------------------------------------------
Name | DR. WILLIAM N ONG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 650-991-7397
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number | 43382
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------