Active NPI
Yen Chun Wang, DDS
- Dentist
- Mesa, AZ
National Provider Identifier
1497812606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D5988
- Practice address
- 6328 E Brown Rd
Suite 101-102
Mesa, AZ 85205-4841 - Phone
- (480) 325-5700
- Fax
- (420) 325-5727
- NPI assigned
- Jan 3, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D5988 | AZ | Primary |
Addresses
Primary practice location
6328 E Brown Rd
Suite 101-102
Mesa, AZ 85205-4841
Mailing address
6328 E Brown Rd
Suite 101-102
Mesa, AZ 85205
Phone (480) 325-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160106002774 | AZ | Order and Referring Only - Dentist | 3375845498 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D5988 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valleywide Sunshine Dental Care LLC | Dentist | Past | Accepting new patients |
| Children's Dental Clinic of Tucson, LLC | Past | Accepting new patients | |
| CKHH Dental PLLC | Past | Accepting new patients | |
| Dentistry Group Foundation, LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- General Practice Dentistry
- Tucson, AZ
- NPI 1861406829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490918400000",
"number": "1497812606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6328 E BROWN RD",
"address_2": "SUITE 101-102",
"city": "MESA",
"state": "AZ",
"postal_code": "85205",
"telephone_number": "480-325-5700",
"fax_number": "480-325-5727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6328 E BROWN RD",
"address_2": "SUITE 101-102",
"city": "MESA",
"state": "AZ",
"postal_code": "852054841",
"telephone_number": "480-325-5700",
"fax_number": "420-325-5727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "YEN",
"middle_name": "CHUN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2017-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D5988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.