Amelia A.M. Wan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9414 Issued in NC

Practice address

1602 Liberty Drive
Thomasville, NC 27360-5750

Phone

(336) 475-8181

Fax

(336) 475-9223

NPI assigned

Aug 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brandyberry & Associates, PLLC

  • Dentist
  • Thomasville, NC
  • NPI 1184897167

  General Practice

  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1164614418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 LIBERTY DRIVE",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273605750",
            "telephone_number": "336-475-8181",
            "fax_number": "336-475-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 LIBERTY DRIVE",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273605750",
            "telephone_number": "336-475-8181",
            "fax_number": "336-475-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "AMELIA",
        "middle_name": "A.M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DTP 484",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #07280)
• Walgreen Co (Rite Aid)
• David Wayne Walker
• Celia Maere Walpole
• Jessica Rose Walukonis, PA-C
• Paul Douglas Ware, O.D.
• Gregory Washington, PA
• Karen Liverman Washington, RPH
• Andrew Watkins, MSW, LCSWA
• Andrea Watson

• General Practice Dentistry in Thomasville, NC
• Providers in Thomasville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.