Individual provider Active NPI

Kuan Wei Tung

  • Endodontics
  • Dearborn, MI
National Provider Identifier
1386522019
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2901602796 Issued in MI
Practice address
22731 Newman St Ste 125
Dearborn, MI 48124-2023
Phone
(313) 565-9118
NPI assigned
Aug 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 2901602796 MI Primary

Addresses

Primary practice location

22731 Newman St Ste 125
Dearborn, MI 48124-2023

Mailing address

200 E 21St St Apt 6D
New York, NY 10010-7400

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
2901602796MIMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontics PC Endodontics CurrentSince Aug 25, 2025 Accepting new patients

Locations

22731 Newman St
Ste 125
Dearborn, MI 48124
Phone (313) 565-9118

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": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1386522019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 21ST ST APT 6D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100107400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22731 NEWMAN ST STE 125",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242023",
            "telephone_number": "313-565-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNG",
        "first_name": "KUAN WEI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901602796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.