Pei Wang, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0401418098 Issued in VA

Practice address

7915 Lake Manassas Dr Ste 203
Gainesville, VA 20155-3259

Phone

(703) 753-4901

NPI assigned

Mar 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1245770544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 N RANDOLPH ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222074813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 LAKE MANASSAS DR STE 203",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553259",
            "telephone_number": "703-753-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "PEI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2025-03-17",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102988",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401418098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Ruth Walker
• Chantalle J Walker, PA-C
• Kehinde Walker, LPC
• Sara Victoria Walker, DPT
• Carolina Walsh, LPC
• Qiuju Wang, LMT
• Warby Parker Inc.
• Gloria Washington
• Watoto Pediatric & Adolescent Specialty, LLC
• Katelynn Weber

• Endodontics in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.