Provider Demographics
NPI:1770166852
Name:KWOK, WING YAU ALEXIS (DMD)
Entity type:Individual
Prefix:DR
First Name:WING YAU ALEXIS
Middle Name:
Last Name:KWOK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:KWOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:28 BOX ST APT N231
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-5586
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4705 44TH ST STE A2
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-6351
Practice Address - Country:US
Practice Address - Phone:718-752-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0624141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice