Ching-Wen Wang, D.M.D.
Individual provider Active NPI General Practice Dentistry · Altavista, VA
NPI 1033629688 · NPPES record last updated Jan 27, 2019
Key facts
- NPI
- 1033629688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401415761 (VA)
- Practice address
- 1208 Main St
Altavista, VA 24517-1434 - Phone
- (434) 369-6244
- NPI assigned
- Oct 10, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401415761 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brenda M Elliott DDS PLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401415761 | VA | Yes |
Addresses
Primary practice location
1208 Main St
Altavista, VA 24517-1434
Mailing address
1208 Main St
Altavista, VA 24517-1434
Phone (434) 369-6244
Other providers in Altavista, VA
- Team Nurse Inc
- The Deheavenly Home, LLC
- VHN Services
- Virginia CVS Pharmacy LLC
- Wal-Mart Stores East LP
- Andrew Ward
- Charles M. West
- David Alan West Sr.
All providers in Altavista, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.