NPIMap

Organization Active NPI

Chuandi Wang Pediatric Dentistry PC

  • Pediatric Dentistry
  • Portage, MI
National Provider Identifier
1205453149
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CHUANDI WANG PEDIATRIC DENTISTRY PC
Practice address
5907 Oakland Dr
Portage, MI 49024-1120
Phone
(269) 327-4459
NPI assigned
Jun 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Authorized official

Name
Chuandi WangNPI 1043531155
Title
Dentist
Phone
(269) 267-5876

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

5907 Oakland Dr
Portage, MI 49024-1120

Mailing address

5907 Oakland Dr
Portage, MI 49024-1120

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL cwpedo@gmail.com
Other URL cwpedo@gmail.com

National Provider Directory

National Provider Directory

Locations

5907 Oakland Dr
Portage, MI 49024
Phone (269) 327-4459

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1205453149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5907 OAKLAND DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490241120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5907 OAKLAND DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490241120",
            "telephone_number": "269-327-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUANDI WANG PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "CHUANDI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "269-267-5876"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cwpedo@gmail.com",
            "affiliation": "N",
            "address_1": "5907 Oakland Dr",
            "city": "Portage",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490241120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cwpedo@gmail.com",
            "affiliation": "N",
            "address_1": "5907 Oakland Dr",
            "city": "Portage",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490241120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

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