Mark D Wang

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106214 Issued in CA

Practice address

1309 N Grand Ave
Walnut, CA 91789-1317

Phone

(909) 594-7899

NPI assigned

Jun 30, 2021

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 and National Provider Directory roles.

• Mark D Wang DMD Inc.

  • Dental Clinic/Center
  • Walnut, CA
  • NPI 1477314250
  NPD Authorized official
• Tien Chun D. Wang D.M.D., Inc

  • General Practice Dentistry
  • Walnut, CA
  • NPI 1659850071
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1174193288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 TIGER LN",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928704349",
            "telephone_number": "909-859-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N GRAND AVE",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891317",
            "telephone_number": "909-594-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MARK",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walnut Physical Therapy and Performance P.C.
• Walnut Silver Town Inc
• Walnut Valley Senior Living Community
• Walnut Valley Unified School District
• Diana Wang, DPT
• Michael Wang, DDS
• Tien Chun D. Wang, DDS
• Yiching Wang
• Yue Wang
• Chen Wen

• General Practice Dentistry in Walnut, CA
• Providers in Walnut, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.