Individual provider Active NPI

Hongli Wang, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Beacon, NY
National Provider Identifier
1063505196
Registry record updated Mar 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
49769 Issued in NY
Practice address
1020 Walcott Ave
Beacon, NY 12508
Phone
(845) 838-3666
Fax
(845) 838-3223
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 49769 NY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 49769 NY Primary

Addresses

Primary practice location

1020 Walcott Ave
Beacon, NY 12508

Mailing address

1020 Walcott Ave
Beacon, NY 12508
Phone (845) 838-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230406001793 NY Practitioner - Oral Surgery 3476928383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49769NYMDOral and Maxillofacial Surgery (Dentist)
049769NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Dental PC CurrentSince Dec 15, 2022 Accepting new patients
Nuvance Health Medical Practice PC PastSince Dec 15, 2022 Accepting new patients

Locations

1020 Wolcott Ave
Beacon, NY 12508
Phone (845) 838-3666

1020 Wolcott Ave
Ste 2
Beacon, NY 12508

Organizations & group practices 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678492800000",
    "number": "1063505196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 WALCOTT AVE",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "12508",
            "telephone_number": "845-838-3666",
            "fax_number": "845-838-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WALCOTT AVE",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "12508",
            "telephone_number": "845-838-3666",
            "fax_number": "845-838-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "HONGLI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-03-11",
        "certification_date": "2023-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "49769",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "49769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beacon, NY

Sources for this page

Verify at the official NPI Registry.