Provider Demographics
NPI:1285625251
Name:FONG, STANLEY KAIPING (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:KAIPING
Last Name:FONG
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 1:1444 WASHO DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-6659
Mailing Address - Country:US
Mailing Address - Phone:510-770-0808
Mailing Address - Fax:510-770-9898
Practice Address - Street 1:2836 S WHITE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2932
Practice Address - Country:US
Practice Address - Phone:408-238-4645
Practice Address - Fax:408-238-8482
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice