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NPI Code Detail

MEDICARE: DR. STEVEN E. WONG DDS

MEDICARE: DR. STEVEN E. WONG DDS
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
11223G0001XGeneral Practice Dentistry53662CA
21223G0001XGeneral Practice Dentistry8294KY
31223G0001XGeneral Practice Dentistry5499NV

General Provider Information

NPI Number : 1063500643
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN E. WONG DDS
Provider Business Mailing Address
First Line : 8037 BRIGHTON SUMMIT AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-1559
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 650 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5382
Country : US
Telephone Number : 702-790-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 06/01/2017

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Directions to “ DR. STEVEN E. WONG DDS” Practice Location

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