Provider Demographics
NPI:1992145783
Name:WONG, WEIYEE (DDS)
Entity type:Individual
Prefix:
First Name:WEIYEE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 GOLDENS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2810
Mailing Address - Country:US
Mailing Address - Phone:914-232-1070
Mailing Address - Fax:914-252-1080
Practice Address - Street 1:190 GOLDENS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536
Practice Address - Country:US
Practice Address - Phone:914-232-1070
Practice Address - Fax:914-232-1080
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0572411223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00401136Medicaid
CT004011367Medicaid