DR. JONATHAN D. PONG (NPI# 1235368978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235368978 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN D. PONG |
| Credential | DMD |
| Practice Address |
3915 Broadway New York NY 10032-1565 |
| Practice Telephone | 2125675536 |
| Practice Fax Number | 2122026447 |
| Mailing Telephone | 2125675536 |
| Mailing Fax Number | 2122026447 |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2013-12-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
056400-1 | NY | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
P51889 | NY | Dental Providers |
| Street Address |
3915 BROADWAY |
| City | NEW YORK |
| State | NY |
| Zip Code | 10032-1565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174573976 | Bradley Adam Hirsch | Dentist | 3915 Broadway, New York, NY 10032-1565 | 2006-05-11 |
| 1013410711 | Kathleen N Hofmann | Student in an Organized Health Care Education/Training Program | 3915 Broadway, New York, NY 10032-1565 | 2018-03-09 |
| 1467604363 | Jesal Virendra Shah | Dentist | 3915 Broadway, New York, NY 10032-1565 | 2008-10-22 |
| 1164679791 | Mckinley L Price II | Dentist | 3915 Broadway, New York, NY 10032-1565 | 2008-08-26 |
| 1366604829 | Mimi Joonyoung Lee | Dentist | 3915 Broadway, New York, NY 10032-1565 | 2008-06-26 |
| 1669684114 | Mohammad W Rabah | Dentist | 3915 Broadway, New York, NY 10032-1565 | 2007-05-05 |
| 1568504538 | Janet C Bodey | Dentist | 3915 Broadway, New York, NY 10032-1565 | 2007-02-13 |
| 1346300787 | Kenneth Wieder | Dentist | 3915 Broadway, New York, NY 10032-1565 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658301 | Julia Sophia White | Registered Nurse | 622 W 168th St, New York, Ny, New York, NY 10032 | 2020-10-29 |
| 1326653411 | Simbarashe S Mudiwa | Massage Therapist | 615 W 165th St, Apt 1b, New York, NY 10032 | 2020-09-15 |
| 1063021335 | Margaret E O'neil | Physical Therapist | 180 Fort Washington St, Harkness 1-164, New York, NY 10032 | 2020-07-23 |
| 1780207480 | Bing Mei Teh | Student in an Organized Health Care Education/Training Program | 180 Fort Washington Ave, Harkness Pavillion 7th Floor, Department of Otolaryngology, New York, NY 10032 | 2020-05-28 |
| 1295354116 | Kavin Fatehchand | Student in an Organized Health Care Education/Training Program | 630 West 168th Street, New York, Ny 10032, New York, NY 10032 | 2020-04-10 |
| 1417584020 | Laura Faye Willard | Student in an Organized Health Care Education/Training Program | 177 Ft. Washington Ave., 7gs-313, New York, NY 10032 | 2020-03-24 |
| 1356976641 | Thomas Joseph Cahill | Student in an Organized Health Care Education/Training Program | Columbia Heart & Valve Center, New York Presbyterian/co, 161 Fort Washington Avenue, Herbert Irving Pavilion 6 F, New York City, NY 10032 | 2020-03-06 |
| 1346874765 | Paulo Roberto De Paula Selber | Orthopaedic Surgery | Department of Orthopedic Surgery - Chony, 3959 Broadway, 8 North, Room 803, New York, NY 10032 | 2020-02-25 |
| 1720611312 | Rachel Dawn Vanderlaan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Newyork-presbyterian Morgan Stanley Children's Hospital, 3959 Broadway Ave Suite: 274, New York, NY 10032 | 2020-02-21 |
| 1881225928 | Daniel Molina Garcia | Social Worker | 180 Fort Washingtion Avenue, 6th Fl, New York, NY 10032 | 2020-01-28 |
| Find all providers in zip 10032 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921643 | Upper West Side Oral & Maxillofacial Surgery | Dentist | 140 W 69th St Ph 1g, New York, NY 10023-5173 | 2020-08-07 |
| 1467092965 | Nyc Implant and Oral Surgery PC | Dentist | 30 E 60th St Ste 907, New York, NY 10022-1058 | 2020-01-13 |
| 1205344819 | Ray Cheng Dds | Dentist | 217 Park Row Ste 4b, New York, NY 10038-1101 | 2018-01-17 |
| 1235541038 | Azaz Awan | Dentist | 335 Malcolm X Blvd, New York, NY 10027-3703 | 2014-05-28 |
| 1699196329 | Majid Jamali, Dmd, P.C. | Dentist | 42 Broadway Ste 1501, New York, NY 10004-1617 | 2013-12-24 |
| 1518268739 | Abdul Basit Karim | Dentist | 1111 Amsterdam Ave # 205, St. Luke's-roosevelt Hospital Center, New York, NY 10025-1716 | 2010-11-04 |
| 1134356157 | Anayo Obi Adachie | Dentist | 10 Union Sq E Ste 5b, New York, NY 10003-3314 | 2009-06-17 |
| 1598991044 | Leslie Abraham | Dentist | 200 E 57th St, Apt 5j, New York, NY 10022-2860 | 2009-06-10 |
| 1316173537 | Jennifer Frangos | Dentist | 13 W 13th St Apt 5bs, Oral & Maxillofacial Surgery, New York, NY 10011-8122 | 2009-06-02 |
| 1821223041 | Marcello Guglielmi | Dentist | 1775 Grand Councourse, 6 Th Floor, Bronx-lebanon Hospital Center, New York, NY 10453 | 2009-05-18 |
| Find all providers in NEW YORK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.