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LOLO WONG D.D.S.
NPI 1073506960
Dentist - Pediatric Dentistry in Dallas, TX

Active since August 25, 2005PECOS Enrolled
3302 GASTON AVE, TEXAS A&M/BAYLOR COLLEGE OF DENTISTRY, DALLAS, TX 75246(214) 828-8456 Get Directions Write a Review

NPPES record last updated: January 30, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lolo Wong D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOLO WONG D.D.S. (NPI 1073506960) is an individual pediatric dentistry provider in Dallas, Texas, licensed in Texas (26344) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and maintains 6 additional practice locations.

NPPES Registry Identity

NPI1073506960
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameLOLO WONGCredential: D.D.S.
Location Address3302 GASTON AVE, TEXAS A&M/BAYLOR COLLEGE OF DENTISTRYDallas, TX 75246-2013
Mailing Address1204 Dickinson DrMckinney, TX 75071-7504 · (972) 632-7915
Phone(214) 828-8456
Sole ProprietorYes
Enumeration DateAugust 25, 2005
Last NPPES UpdateJanuary 30, 2025
NPPES CertifiedJanuary 30, 2025
✔ NPI 1073506960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in TX · 26344
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
3302 GASTON AVE, Dallas, TX 75246
Open in Google Maps ↗

Secondary Practice Locations 6

Location 11935 Medical District DrDallas, TX 75235-7701 · Phone (214) 456-8800 · Fax (214) 456-8812
Location 26300 Harry Hines BlvdDallas, TX 75235-5259 · Phone (214) 456-8800 · Fax (214) 456-8812
Location 31250 W Mockingbird Ln Ste 500Dallas, TX 75247-6934 · Phone (214) 456-8800 · Fax (214) 456-8812
Location 43800 Gaylord Pkwy Ste 850Frisco, TX 75034-0248 · Phone (469) 857-2222
Location 52222 Welborn StDallas, TX 75219-3924 · Phone (214) 559-5000 · Fax (214) 443-7309
Location 65700 Dallas PkwyFrisco, TX 75034-9580 · Phone (469) 515-7100

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lolo Wong D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lolo Wong reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Texas Scottish Rite Hospital For Crippled Children
2.1 mi
Pediatric Orthopaedic Surgery
2222 WELBORN ST
Dallas, TX 75219
  • Reassigned Medicare billing, Texas enrollment
  • 179 clinicians in this Medicare group
NPI 1598188948 (214) 559-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75246 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIANNA TREY CALABRIA
Dentist (General Practice)
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8100
AIMEE ANDREINA DIAZ
Student in an Organized Health Care Education/Training Program
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8215
BRENDA HERNANDEZ MOCTEZUMA
Dental Hygienist
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8100
TERESA ANH PHUONG NGUYEN DMD
Student in an Organized Health Care Education/Training Program
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8215
GRANT KASAL
Student in an Organized Health Care Education/Training Program
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8215
SAAD ULLAH MOHAMMED
Student in an Organized Health Care Education/Training Program
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8100
MAHA ACHOUR
Student in an Organized Health Care Education/Training Program
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8215
MEAGAN HALL
Student in an Organized Health Care Education/Training Program
3302 GASTON AVE
DALLAS, TX 75246
Dallas County (214) 828-8100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lolo Wong's NPI number?

The NPI number for Lolo Wong is 1073506960. It was assigned to this individual provider in the NPPES registry on August 25, 2005.

Where is Lolo Wong located?

Lolo Wong practices at 3302 Gaston Ave Texas A&m/Baylor College Of Dentistry, Dallas, TX 75246. The listed phone number is (214) 828-8456.

What is Lolo Wong's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Lolo Wong enrolled in Medicare?

Yes. Lolo Wong is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lolo Wong's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lolo Wong reassigns Medicare benefits to Texas Scottish Rite Hospital For Crippled Children (Dallas, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lolo Wong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lolo Wong accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 11 other insurers list Lolo Wong as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lolo Wong was last updated on January 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.