Su-Min Wang, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

36030 Issued in CA

Practice address

24541 Pacific Park Dr
Suite 104
Aliso Viejo, CA 92656-3065

Phone

(949) 362-9860

Fax

(949) 362-4802

NPI assigned

Mar 26, 2013

Sex

Female

Sole proprietor

Yes

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

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.

• Su-Min Wang Professional Dental Corporation

  • Pediatric Dentistry
  • Aliso Viejo, CA
  • NPI 1679782718
  NPD (past) Authorized official

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1134461353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR",
            "address_2": "SUITE 104",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563065",
            "telephone_number": "949-362-9860",
            "fax_number": "949-362-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR",
            "address_2": "SUITE 104",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563065",
            "telephone_number": "949-362-9860",
            "fax_number": "949-362-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SU-MIN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "36030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wahle Pharmacy
• Walgreen Co
• Kristen M. Walters, MD
• Alisa Wang, PA-C
• Jian-Feng Wang
• William E Wang, D.D.S.
• Natasha Warrick
• Warrior Wisdom Wellness, Inc.
• Justin Sprague Weber
• Michelle Ann Weinandy, M.P.T.

• Pediatric Dentistry in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.