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DR. BRIAN B FONG DMD, MD
NPI 1609927425
Dentist - Oral and Maxillofacial Surgery in Elk Grove, CA

Active since January 16, 2007Opted out of Medicare · through Aug 18, 2027
9390 BIG HORN BLVD., SUITE 100, ELK GROVE, CA 95758(916) 683-7777(916) 683-8009 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Brian B Fong Dmd, Md NPPES

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

DR. BRIAN B FONG DMD, MD (NPI 1609927425) is an individual oral and maxillofacial surgery provider in Elk Grove, California, licensed in California (51473) and active in the NPI registry since January 2007. He has opted out of Medicare through August 18, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1609927425
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. BRIAN B FONGCredential: DMD, MD
Location Address9390 BIG HORN BLVD., SUITE 100Elk Grove, CA 95758
Mailing Address9390 Big Horn Blvd., Suite 100Elk Grove, CA 95758 · (916) 683-7777 · Fax (916) 683-8009
Phone(916) 683-7777
Fax(916) 683-8009
Sole ProprietorYes
Enumeration DateJanuary 16, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1609927425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in CA · 51473
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
9390 BIG HORN BLVD., Elk Grove, CA 95758
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Brian B Fong Dmd, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 18, 2015 through August 18, 2027.

Opt-Out Effective DateAugust 18, 2015
Opt-Out In Effect ThroughAugust 18, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95758 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$75.03 typical visit price
range $19.88 – $148.15
Typical copayment $18.75 (range $4.97 – $37.03)
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.

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 Brian Fong's NPI number?

The NPI number for Brian Fong is 1609927425. It was assigned to this individual provider in the NPPES registry on January 16, 2007.

Where is Brian Fong located?

Brian Fong practices at 9390 Big Horn Blvd. Suite 100, Elk Grove, CA 95758. The listed phone number is (916) 683-7777.

What is Brian Fong's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Brian Fong enrolled in Medicare?

No. Brian Fong has opted out of Medicare through August 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Brian Fong was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.