Provider Demographics
NPI:1134478043
Name:ONG, HAMLET H (DDS)
Entity Type:Individual
Prefix:
First Name:HAMLET
Middle Name:H
Last Name:ONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17906 S. PIONEER BLVD., #100
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701
Mailing Address - Country:US
Mailing Address - Phone:562-860-9612
Mailing Address - Fax:562-860-5343
Practice Address - Street 1:17906 S. PIONEER BLVD., #100
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701
Practice Address - Country:US
Practice Address - Phone:562-860-9612
Practice Address - Fax:562-860-5343
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA369961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice