Active NPI
Chenyu Wang, DMD
- Dentist
- Winslow, ME
National Provider Identifier
1275104630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN4897
- Practice address
- 334 Augusta Rd
Winslow, ME 04901-7167 - Phone
- (207) 204-4307
- NPI assigned
- Jul 7, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN4897 | ME | Primary |
Addresses
Primary practice location
334 Augusta Rd
Winslow, ME 04901-7167
Mailing address
39A Baker Rd
Freeport, ME 04032-6626
Phone (267) 566-0467
Other names 1
- Ken Wang
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN4897 | ME | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625616000000",
"number": "1275104630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39A BAKER RD",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326626",
"telephone_number": "267-566-0467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "334 AUGUSTA RD",
"city": "WINSLOW",
"state": "ME",
"postal_code": "049017167",
"telephone_number": "207-204-4307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "CHENYU",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-07",
"last_updated": "2021-07-07",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ME",
"license": "DEN4897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KEN",
"last_name": "WANG",
"credential": "DMD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Winslow, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.