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NPI Code Detail

MEDICARE: PATRICIA M. WONG DDS, DENTAL PC

MEDICARE: PATRICIA M. WONG DDS, DENTAL PC
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 Dentistry

General Provider Information

NPI Number : 1790643112
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATRICIA M. WONG DDS, DENTAL PC
Provider Business Mailing Address
First Line : 1530 JUDAH ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94122-1718
Country : US
Telephone Number : 415-759-8680
Fax Number : 415-759-8629
Provider Business Practice Location Address
First Line : 1530 JUDAH ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94122-1718
Country : US
Telephone Number : 415-759-8680
Fax Number : 415-759-8629
Authorized Official
Title or Position : PRESIDENT
Name : PATRICIA M WONG
Credential : DDS
Telephone Number : 415-759-8680
Provider Enumeration Date : 01/14/2026
Last Update Date : 01/14/2026

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