Provider Demographics
NPI:1477605269
Name:ONG, HOWARD (DDS)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
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 1:805 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6309
Mailing Address - Country:US
Mailing Address - Phone:562-596-1621
Mailing Address - Fax:562-596-1142
Practice Address - Street 1:805 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6309
Practice Address - Country:US
Practice Address - Phone:562-596-1621
Practice Address - Fax:562-596-1142
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA813660OtherUNITED CONCORDIA PROVIDER
CA1338498OtherUNITED CONCORDIA PROVIDER