Organization Active NPI

Lawrence Wang

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1255567053
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
052336 Issued in NY
Legal business name
LAWRENCE WANG
Practice address
1158 Broadway
3Rd Floor
New York, NY 10001-7506
Phone
(917) 584-0824
NPI assigned
Jun 8, 2009
Last updated
Jun 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Authorized official

Name
Dr. Lawrence Y Wang, DDS
Title
Owner/DDS
Phone
(917) 584-0824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 052336 NY Primary

Addresses

Primary practice location

1158 Broadway
3Rd Floor
New York, NY 10001-7506

Mailing address

2220 65TH St
Brooklyn, NY 11204-4035
Phone (917) 584-0824

Other identifiers 1

IdentifierTypeStateIssuer
02713422MedicaidNY

National Provider Directory

National Provider Directory

Locations

1158 Broadway
Fl 3
New York, NY 10001
Phone (212) 213-4029

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1255567053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 65TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044035",
            "telephone_number": "917-584-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 BROADWAY",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017506",
            "telephone_number": "917-584-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE WANG",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "917-584-0824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02713422",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.