Active NPI
Robert S Wang, D.M.D., M.S.
- Pediatric Dentistry
- Corona, CA
National Provider Identifier
1386815538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 50694
- Practice address
- 260 E Ontario Ave Ste 203
Corona, CA 92879-3507 - Phone
- (951) 898-9966
- Fax
- (928) 833-9966
- NPI assigned
- Mar 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 50694 | CA | Primary |
Addresses
Primary practice location
260 E Ontario Ave Ste 203
Corona, CA 92879-3507
Mailing address
260 E Ontario Ave Ste 203
Corona, CA 92879-3507
Phone (951) 898-9966
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50694 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226102400000",
"number": "1386815538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 E ONTARIO AVE STE 203",
"city": "CORONA",
"state": "CA",
"postal_code": "928793507",
"telephone_number": "951-898-9966",
"fax_number": "928-833-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 E ONTARIO AVE STE 203",
"city": "CORONA",
"state": "CA",
"postal_code": "928793507",
"telephone_number": "951-898-9966",
"fax_number": "928-833-9966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "ROBERT",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-17",
"last_updated": "2008-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "50694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.