Provider Demographics
NPI:1619043775
Name:CHONG, WONIL WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:WONIL
Middle Name:WILLIAM
Last Name:CHONG
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 1:36 MDG/SGS
Mailing Address - Street 2:UNIT 14010, BLDG 26001
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 MDG/SGS
Practice Address - Street 2:UNIT 14010
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96543
Practice Address - Country:US
Practice Address - Phone:671-366-2324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD136861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice