JEFFREY FONG (NPI# 1790076735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790076735 |
| Entity Type | Individual |
| Full Name | JEFFREY FONG |
| Credential | D.D.S. |
| Practice Address |
9411 65th Rd Suite 1b Rego Park NY 11374-4627 |
| Practice Telephone | 3746825688 |
| Mailing Telephone | 3476825688 |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2015-10-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
056689-1 | NY | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
22DI02502400 | NJ | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295862738 | Jeffrey J. Fong | Pharmacist | 16 Harley St, Dorchester Center, MA 02124-3609 | 2007-02-28 |
| 1255797080 | Jeffrey Fong | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2016-01-08 |
| 1093893695 | Jeffrey S. Fong | Internal Medicine | 2200 Ofarrell St, San Francisco, CA 94115-3357 | 2006-11-01 |
| 1326017708 | Jeffrey A Fong | Psychologist | 9601 Steilacoom Blvd Sw, Tacoma, WA 98498-7213 | 2006-03-16 |
| Street Address |
9411 65TH RD SUITE 1B |
| City | REGO PARK |
| State | NY |
| Zip Code | 11374-4627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134747579 | Washington Andres Sanchez | Occupational Therapist | 61 80 Woodhaven Blvd, Rego Park, NY 11374 | 2020-07-13 |
| 1285261636 | Joanna Rucinska | Home Health Aide | 6140 Wetherole Street, Rego Park, NY 11374 | 2020-03-25 |
| 1134605751 | Ella Yusupova | Specialist | 6620 Wetherole Street, Apt#2d, Rego Park, NY 11374 | 2018-07-17 |
| 1316435290 | Ilya Nektalov | Pharmacist | 9002 63rd Dr Apt 2h, Rego Park, NY 11374 | 2018-04-26 |
| 1467956623 | Celeste Lucas-powers | Social Worker | 97-37 Queens Blvd, Queens, NY 11374 | 2018-03-22 |
| 1306358114 | Mazal Katanov-nektalov | Occupational Therapist | 65-09 99th St, Apt.1t, Rego Park Queens,ny, NY 11374 | 2017-11-02 |
| 1497273866 | Alex Adrian Medina Abragan | Physical Therapist | 8616 63rd Drive, 2nd Floor, Rego Park, NY 11374 | 2017-09-06 |
| 1417472374 | Natella Yagoudaeva | Physician Assistant | 65-60 Wetherole St. Apt 4d, Rego Park, NY 11374 | 2017-08-11 |
| 1477083491 | Kei Petersen | Social Worker | Rego Park Counseling Center, 97-77 Queens Blvd., Ph Floor, Rego Park, NY 11374 | 2017-06-13 |
| 1558890988 | Irina Simidchieva | 6210 99th Street, Apt.6a, Rego Park, NY 11374 | 2017-06-08 | |
| Find all providers in zip 11374 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669859294 | Lil Pearls Pediatric Dentistry Pllc | Dentist | 94-11 65th Rd, Suite 1b, Rego Park, NY 11374 | 2015-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557059 | Smiles and Grins Pediatric Dentistry | Dentist | 160 E 88th St Apt 1d, New York, NY 10128-2217 | 2020-10-30 |
| 1891395810 | Ez Orthodontics Pllc | Dentist | 4010 82nd St Fl 2, Elmhurst, NY 11373-1305 | 2020-10-28 |
| 1346858677 | Kids Dental of Queens PC | Dentist | 4236 82nd St # C, Elmhurst, NY 11373-3537 | 2020-07-22 |
| 1073131512 | Prohealth Dental Pllc | Dentist | 2318 31st St Ste 320, Astoria, NY 11105-2765 | 2020-07-10 |
| 1952929911 | Kiddsmiles Pediatric Dentistry 7 Pllc | Dentist | 263 Jericho Tpke, Floral Park, NY 11001-2146 | 2020-07-07 |
| 1376177782 | Pco Ortho LLC | Dentist | 3422 35th St, Long Island City, NY 11106-1268 | 2020-02-24 |
| 1033749916 | Yehuda Marciano Dds PC | Dentist | 932 Broadway Ste 1, Woodmere, NY 11598-1723 | 2020-01-20 |
| 1710521752 | Asnis Dental Pllc | Dentist | 800 N Broadway, Massapequa, NY 11758-2335 | 2019-11-02 |
| 1760026777 | Dr. Stephen A Festa-pediatric Dentistry Pllc | Dentist | 3755 76th St Bsmt Apt, Jackson Heights, NY 11372-6552 | 2019-11-01 |
| 1841849965 | Woodrow Little Smiles Family Dentistry P.C. | Dentist | 739 Woodrow Road, Staten Island, NY 10312 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.