| Doctor Name: | DR. ALICIA K WONG |
| NPI Number: | 1003841347 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DMD, MPH |
| License Number: | DE00009888 |
| Business Practice Address: | 914 140th Ave Ne Suite 101 Bellevue, WA - 980053482 |
| Business Phone Number: | 4254011147 |
| Business Fax Number: | 4254846424 |
| Mailing Address: | 914 140th Ave Ne, Suite 101 BELLEVUE |
| State: | WA |
| Postal Code: | 980053482 |
| Phone Number: | 4254011147 |
| Fax Number: | 4254846424 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 02/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | DE00009888 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |