Dr Lawrence Eugene Fong, DDS is a medicare enrolled "Dentist - General Practice" provider in Fairfax, California. His current practice location is
61a Broadway Blvd, Fairfax, California. You can reach out to his office (for appointments etc.) via phone at
(415) 457-3377.
Dr Lawrence Eugene Fong is licensed to practice in California (license number 22068) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1366652117.
Healthcare Provider's Profile
Full Name | Dr Lawrence Eugene Fong |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 61a Broadway Blvd, Fairfax, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1366652117
- Provider Enumeration Date: 05/23/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 2264731017
- Enrollment ID: I20160428000756
Medical Identifiers
Medical identifiers for Dr Lawrence Eugene Fong such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1366652117 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 22068 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lawrence Eugene Fong is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Lawrence Eugene Fong, DDS 61a Broadway Blvd, Fairfax, CA 94930-1653 Ph: (415) 457-3377 | Dr Lawrence Eugene Fong, DDS 61a Broadway Blvd, Fairfax, CA 94930-1653 Ph: (415) 457-3377 |
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