Kelly Fong, DDS is a
Student In An Organized Health Care Education/training Program based in Philadelphia, Pennsylvania. Kelly Fong is licensed to practice in Pennsylvania (license number ) and their current practice location is
240 S 40th St, Philadelphia, Pennsylvania. This provider can be reached at their office (for appointments etc.) via phone at
(215) 898-6555.
NPI number for Kelly Fong is 1295524213 and their current mailing address is 244 Moncada Way, San Francisco, California. This provider
does not participate in medicare program and thus does not accept medicare assignments. Their NPI Number is 1295524213.
Healthcare Provider's Profile
| Full Name | Kelly Fong |
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| Gender | |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 240 S 40th St, Philadelphia, Pennsylvania |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. This provider may not accept medicare assignment. |
NPI Data:
- NPI Number: 1295524213
- Provider Enumeration Date: 05/05/2025
- Last Update Date: 07/16/2026
Medical Identifiers
Medical identifiers for Kelly Fong such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1295524213 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1223G0001X | Dentist - General Practice | DDS110547 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Pennsylvania) | 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. Kelly Fong is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Kelly Fong, DDS 244 Moncada Way, San Francisco, CA 94127-2706 Ph: (415) 361-2632 | Kelly Fong, DDS 240 S 40th St, Philadelphia, PA 19104-6030 Ph: (215) 898-6555 |
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