Edward J Wang, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60861774 Issued in WA

Practice address

20709 Mountain Hwy E # 101
Spanaway, WA 98387-8580

Phone

(253) 948-0879

NPI assigned

Aug 21, 2018

Last updated

Mar 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Willamette Dental Group, P.C.

  • Dentist
  • Tacoma, WA
  • NPI 1881520880
  NPD (past)

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1376023101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20709 MOUNTAIN HWY E # 101",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878580",
            "telephone_number": "253-948-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20709 MOUNTAIN HWY E # 101",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878580",
            "telephone_number": "253-948-0879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5606 Lakewood Towne Center Blvd SW Ste B",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984993894",
            "country_code": "US",
            "telephone_number": "253-680-5273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60861774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Abraxas Waits, LSWAIC
• Wal-Mart Stores, Inc (Vision Center 30-3218)
• Walmart Inc. (Walmart Pharmacy 10-3218)
• Hallie Rose Lim Walsh
• Dongxia Wang
• Kelsey Wardlow
• Ryan Alexis Ware
• Warm Touch Afh
• Kathryn Washburn, RN
• Jordan Watson, RD

• General Practice Dentistry in Spanaway, WA
• Providers in Spanaway, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.