Provider Demographics
NPI:1174641419
Name:TONG, JAMES (DMD, MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:DMD, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 RUSSELL AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3584
Mailing Address - Country:US
Mailing Address - Phone:301-216-1780
Mailing Address - Fax:301-258-2800
Practice Address - Street 1:803 RUSSELL AVE STE 2A
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3584
Practice Address - Country:US
Practice Address - Phone:301-216-1780
Practice Address - Fax:301-258-2800
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD123631223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry