Gregory Wang, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60789841 Issued in WA

Practice address

22010 17TH Ave SE Ste B
Bothell, WA 98021-8486

Phone

(425) 481-8571

NPI assigned

Oct 25, 2013

Last updated

Oct 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Gregory G. Wang, DDS, PLLC

  • Dental Clinic/Center
  • Bothell, WA
  • NPI 1144062001
  NPD Authorized official
• Fang Sun, DDS,PHD,PLLC

  dba Fidler on the Tooth

  • Dentist
  • Seattle, WA
  • NPI 1093609075
  NPD (past)
• Vicki Fidler DDS PS

  dba Fidler on the Tooth

  • Dental Clinic/Center
  • Seattle, WA
  • NPI 1871337477
  NPD (past)
• Mark Whitney Jumper II, D.D.S., P.a.

  dba Aloha Dental

  • General Practice Dentistry
  • Austin, TX
  • NPI 1457517773
  NPD (past)

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1083042204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22010 17TH AVE SE STE B",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218486",
            "telephone_number": "425-481-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22010 17TH AVE SE STE B",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218486",
            "telephone_number": "425-481-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-25",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60789841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britney Walls
• Casey Walsh, ND, PHD
• Jessica Renae Walton
• Xin Wan, RPH
• Dimay Wang, IR
• Jennifer Han Ju Wang, PHARMD
• Karen Wang, DDS
• Kun Wang
• Ping Wang, CMT
• Carol Ward

• General Practice Dentistry in Bothell, WA
• Providers in Bothell, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.