Individual provider Active NPI

Chao Wen Wang, DDS MS PEDIATRIC DEN

  • Pediatric Dentistry
  • Fremont, CA
National Provider Identifier
1043480916
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
40127 Issued in CA
Practice address
2147 Mowry Ave Ste A4
Fremont, CA 94538-1724
Phone
(510) 494-9788
Fax
(510) 471-7427
NPI assigned
Mar 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X AC17846 CA
Pediatric Dentistry 1223P0221X 40127 CA Primary

Addresses

Primary practice location

2147 Mowry Ave Ste A4
Fremont, CA 94538-1724

Mailing address

2147 Mowry Ave Ste A4
Fremont, CA 94538-1724
Phone (510) 494-9788

Other practice location 1

24700 Calaroga Ave Ste 104
Hayward, CA 94545-2160
Phone (510) 785-9295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
40127CAMDPediatric Dentist
AC17846CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Chaowen Wang DDS Inc Single Specialty Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1043480916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 MOWRY AVE STE A4",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381724",
            "telephone_number": "510-494-9788",
            "fax_number": "510-471-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 MOWRY AVE STE A4",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381724",
            "telephone_number": "510-494-9788",
            "fax_number": "510-471-7427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24700 Calaroga Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945452160",
            "country_code": "US",
            "telephone_number": "510-785-9295",
            "fax_number": "510-785-9412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "CHAO WEN",
        "name_prefix": "Dr.",
        "credential": "DDS MS PEDIATRIC DEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17846",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "40127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.