Individual provider Active NPI

I-Ching Wang, DDS, MS

  • Periodontics
  • Columbus, OH
National Provider Identifier
1184216756
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
71.000291 Issued in OH
Practice address
305 W 12TH Ave
Columbus, OH 43210-1267
Phone
(614) 292-1472
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2901600801 MI
Periodontics 1223P0300X 40203 IA
Periodontics 1223P0300X 71.000291 OH Primary

Addresses

Primary practice location

305 W 12TH Ave
Columbus, OH 43210-1267

Mailing address

305 W 12TH Ave
Columbus, OH 43210-1267
Phone (614) 292-1472

Other practice location 1

1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 764-9148

Other practice location 2

801 Newton Rd
Iowa City, IA 52242-1001
Phone (319) 335-7440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20210812001398 IA Practitioner - Oral Surgery 2466856406 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2901600801MIMDPeriodontist
71.000291OHMDPeriodontist
40203IAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jul 30, 2021 Accepting new patients
State University of Iowa CurrentSince Jul 30, 2021 Accepting new patients

Locations

322 Dental Science S
Iowa City, IA 52242
Phone (319) 335-7342

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

322 Dental Science S
Bldg S
Iowa City, IA 52242
Phone (319) 384-1139

Interoperability endpoints

  • Direct secure messaging: iwang1542747@direct.osumc.edu

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": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1184216756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W 12TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-292-1472",
            "fax_number": "319-335-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W 12TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-292-1472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 N University Ave",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481091078",
            "country_code": "US",
            "telephone_number": "734-764-9148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Newton Rd",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421001",
            "country_code": "US",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "I-CHING",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901600801",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IA",
            "license": "40203",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "71.000291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.