Active NPI
Lawrence Wang
- General Practice Dentistry
- New York, NY
National Provider Identifier
1255567053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 052336
- 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, 2009
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02713422 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
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.