Individual provider Active NPI

Michael Wang, DDS

  • Dentist
  • South El Monte, CA
National Provider Identifier
1336613512
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111629 Issued in CA
Practice address
10414 Vacco St
South El Monte, CA 91733-3350
Phone
(626) 281-3383
NPI assigned
Jan 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 111629 CA Primary

Addresses

Primary practice location

10414 Vacco St
South El Monte, CA 91733-3350

Mailing address

419 N Chandler Ave Unit 423
Monterey Park, CA 91754-7785
Phone (408) 858-2298

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
111629CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Buddhist Tzu CHI Medical Foundation CurrentSince Aug 24, 2025 Accepting new patients
Buddhist Tzu CHI Medical Foundation CurrentSince Jul 9, 2025 Accepting new patients

Locations

1000 S Garfield Ave
Alhambra, CA 91801
Phone (626) 281-3383

10414 Vacco St
South El Monte, CA 91733
Phone (626) 281-3383

Organizations & group practices 2

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": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1336613512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N CHANDLER AVE UNIT 423",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917547785",
            "telephone_number": "408-858-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10414 VACCO ST",
            "city": "SOUTH EL MONTE",
            "state": "CA",
            "postal_code": "917333350",
            "telephone_number": "626-281-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-21",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.