Jimmy I. Wang, DDS, a Professional Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

51387 Issued in CA

Legal business name

JIMMY I. WANG, DDS, A PROFESSIONAL CORPORATION

Practice address

10432 Reserve Drive
Suite 110
San Diego, CA 92127

Phone

(858) 487-6428

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Jimmy I Wang, DDSNPI 1003956517

Title

President

Phone

(858) 487-6428

Specialties & licenses 1

Addresses

Other names 1

• Dentistry at 4S Ranch Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jimmy I Wang, DDS

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1003956517
  NPD (past) Authorized official
• Howard Ian Katz, DDS

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1376694430
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194930982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11775 SCRIPPS LAKE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921312374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10432 RESERVE DRIVE",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92127",
            "telephone_number": "858-487-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY I. WANG, DDS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-487-6428",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "51387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentistry at 4S Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa Linda Jimenez
• Vivian Guadalupe Jimenez
• Vivianna Jimenez
• Brieanna Jimmi
• Nichole Jimmi
• Ara Jin, NP
• Christopher Jin, MD
• Chulho Jin
• Hangqing Jin, D.D.S
• Hua Jin, M.D

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.