Li Wang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

21577 Issued in MA

Practice address

2181 Washington St
Suite 101
Roxbury, MA 02119-2082

Phone

(617) 427-5665

Fax

(617) 445-2708

NPI assigned

Oct 28, 2006

Sex

Female

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 MA

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 and National Provider Directory roles.

• Hathaway Road Dental, PC

  • General Practice Dentistry
  • Roxbury, MA
  • NPI 1598852048
  NPD (past)

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376629659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 HARRISON AVE",
            "address_2": "APT # 1206",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184002",
            "telephone_number": "617-838-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021192082",
            "telephone_number": "617-427-5665",
            "fax_number": "617-445-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Eastern Co Inc
• Kristan Walker
• Dorothy Walsh, MED
• Anne Marie Wamba, MA
• Jielin Wang, DMD
• Zhiyi Wang
• Leonard Wanta, DPT
• Ali Wantimba
• Raia Warfield
• Denita Washington

• Dentist in Roxbury, MA
• Providers in Roxbury, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.