Individual provider Active NPI

Rosemary Wei Wei Wang, DDS

  • General Practice Dentistry
  • Los Gatos, CA
National Provider Identifier
1376762518
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38620 Issued in CA
Practice address
812 Pollard Rd
Suite #8
Los Gatos, CA 95032
Phone
(408) 379-0885
Fax
(408) 379-1782
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38620 CA Primary

Addresses

Primary practice location

812 Pollard Rd
Suite #8
Los Gatos, CA 95032

Mailing address

812 Pollard Rd
Suite #8
Los Gatos, CA 95032
Phone (408) 379-0885

Other identifiers 1

IdentifierTypeStateIssuer
38620MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20210312002385 CA Order and Referring Only - DentistPractitioner - Dentist 5496161689

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38620CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rosemary Wang DDS Inc Past Accepting new patients

Organizations & group practices 1

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1376762518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 POLLARD RD",
            "address_2": "SUITE #8",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-379-0885",
            "fax_number": "408-379-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 POLLARD RD",
            "address_2": "SUITE #8",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-379-0885",
            "fax_number": "408-379-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "ROSEMARY",
        "middle_name": "WEI WEI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.