Provider Demographics
NPI:1720059702
Name:WONG, HOI SZE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOI SZE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HOI SZE
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:450 4TH AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4430
Mailing Address - Country:US
Mailing Address - Phone:619-425-1800
Mailing Address - Fax:619-425-1802
Practice Address - Street 1:450 4TH AVE STE 409
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4430
Practice Address - Country:US
Practice Address - Phone:619-425-1800
Practice Address - Fax:619-425-1802
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554901223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1720059702OtherNOT AFFILIATED WITH MEDICARE