Individual provider Active NPI

Lily Wang, DDS

  • Dentist
  • Arcadia, CA
National Provider Identifier
1386128270
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103243 Issued in CA
Practice address
624 W Duarte Rd Ste 204
Arcadia, CA 91007-9263
Phone
(626) 447-0934
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 103243 CA Primary

Addresses

Primary practice location

624 W Duarte Rd Ste 204
Arcadia, CA 91007-9263

Mailing address

8941 Emperor Ave
San Gabriel, CA 91775-1917
Phone (626) 927-8311

Other practice location 1

624 W Duarte Rd
Arcadia, CA 91007-7603
Phone (626) 447-0934

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
I20181129002688 CA Order and Referring Only - DentistPractitioner - Dentist 3173867256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Han Dental, Apc 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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1386128270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8941 EMPEROR AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917751917",
            "telephone_number": "626-927-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD STE 204",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079263",
            "telephone_number": "626-447-0934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 W Duarte Rd",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910077603",
            "country_code": "US",
            "telephone_number": "626-447-0934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "LILY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.