DR. JACQUELINE J WONG (DDS, MSD) – Dentist, NPI 1417315490
Dentist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
40 ORAL SURGERY in WA
Provider Addresses for DR. JACQUELINE J WONG (DDS, MSD)
1959 NE PACIFIC ST
SEATTLE, WA 981953926
Phone: (206) 685-2937
Type: Location
1202 MARTIN LUTHER KING JR WAY
TACOMA, WA 984053926
Phone: (253) 441-4743
Type: Location
8105 166th Ave NE Ste 103
Redmond, WA 980523999
Phone: (425) 300-9056
Fax: (425) 300-9057
Type: Location
8230 NE 124TH PL
KIRKLAND, WA 980342572
Phone: (253) 234-4203
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-09-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160928002606 | I | Oral Surgery | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98195)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Oral Surgery | WA | |
| P R O S T H O D O N T I C S | WA | |
| Oral Medicine | WA | |
| Oral And Maxillofacial Pathology | WV | |
| Oral Surgery, Maxillofacial Surgery | WA | |
| D E N T I S T | WA | |
| Oral Surgery | WA | |
| Maxillofacial Surgery, Oral Surgery | WA | |
| Dentist, Oral Surgery | WA | |
| D E N T I S T | WA |
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