Individual provider · Type 1 NPI

Kelly Fong, DDS

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1295524213 Active

Practice location

240 S 40th St
Philadelphia, PA 19104-6030

Call (215) 898-6555 Map

Mailing address

244 Moncada Way
San Francisco, CA 94127-2706

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry 1223G0001XDDS110547 (CA)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1295524213

Kelly Fong, DDS's National Provider Identifier is 1295524213, issued on May 5, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 16, 2026.