Provider Demographics
NPI:1770617250
Name:WONG, STANLEY KIN-SHING (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:KIN-SHING
Last Name:WONG
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 1:2120 CARLMONT DR
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3488
Mailing Address - Country:US
Mailing Address - Phone:650-592-6800
Mailing Address - Fax:650-592-6865
Practice Address - Street 1:2120 CARLMONT DR
Practice Address - Street 2:SUITE # 3
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3488
Practice Address - Country:US
Practice Address - Phone:650-592-6800
Practice Address - Fax:650-592-6865
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42964122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist