Wing Djaya, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7332 Issued in OR

Practice address

1230 George St
Woodburn, OR 97071

Phone

(503) 981-3603

NPI assigned

May 12, 2006

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 OR

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

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.

• Kaisky

  • Clinic/Center
  • McMinnville, OR
  • NPI 1730856774
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1386694883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 GEORGE ST",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 GEORGE ST",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071",
            "telephone_number": "503-981-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJAYA",
        "first_name": "WING",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holley Jean Deshaw, L.M.T.
• Steven A. Deshaw, D.C.
• Katherine Desio-Scott, LCSW
• Margarita Diaz
• Yesica Virjinia Diosdado Estrada I
• Jenna Marie Donaldson, MD
• Theresa Donavant-Butler, LMT9185
• Cassandra Dotson
• Hannah Drill
• Jennifer Duarte

• General Practice Dentistry in Woodburn, OR
• Providers in Woodburn, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.