DR. PHILLIP WONG D.M.D NPI 1417331067

NPI Information

DR. Phillip Wong, D.M.D is a general practice dentist in Indianapolis, IN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Phillip Wong, D.M.D NPI is 1417331067. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1121 W MICHIGAN ST # S110B
INDIANAPOLIS, IN
ZIP 46202-211
Phone: (317) 593-5375

The NPI 1417331067 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/14/2015 and was last updated on 10/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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