# DR. JACQUELINE J WONG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1417315490
- **Gender:** F
- **Credential:** DDS, MSD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE60657443 | WA | Yes |
| 122300000X | Dentist | RR 60576274 | WA | — |
| 125Q00000X | Oral Medicine Dentistry | DE60657443 | WA | — |

## Other

- **Enumeration date:** 02/04/2016
- **Last updated:** 10/23/2025