Individual provider Active NPI

Jia Wang

  • Dental Hygienist
  • Sunnyvale, CA
National Provider Identifier
1235915992
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
36123 Issued in CA
Practice address
1565 Hollenbeck Ave Ste 116
Sunnyvale, CA 94087-4394
Phone
(408) 736-6856
Fax
(408) 736-8606
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X 36123 CA Primary

Addresses

Primary practice location

1565 Hollenbeck Ave Ste 116
Sunnyvale, CA 94087-4394

Mailing address

1565 Hollenbeck Ave Ste 116
Sunnyvale, CA 94087-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
36123CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
GCG Surgery Center PastSince Sep 10, 2023 Accepting new patients

Organizations & group practices 1

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": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1235915992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 HOLLENBECK AVE STE 116",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940874300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 HOLLENBECK AVE STE 116",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940874394",
            "telephone_number": "408-736-6856",
            "fax_number": "408-736-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "36123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.