Provider Demographics
NPI:1346362274
Name:TONG, MING FAI TOMMY (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:MING FAI
Middle Name:TOMMY
Last Name:TONG
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6174 MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-4424
Mailing Address - Country:US
Mailing Address - Phone:408-997-6449
Mailing Address - Fax:
Practice Address - Street 1:7880 WREN AVE STE C132
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7801
Practice Address - Country:US
Practice Address - Phone:408-842-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371731223P0300X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223P0300XDental ProvidersDentistPeriodontics
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics