Connie Wang, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

103095 Issued in CA

Practice address

930 16TH St
San Francisco, CA 94107

Phone

(415) 890-4449

NPI assigned

Feb 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1508306267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 MARTIN LUTHER KING DR",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 16TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94107",
            "telephone_number": "415-890-4449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 McCauley St Apt B",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275162633",
            "country_code": "US",
            "telephone_number": "919-801-8875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "CONNIE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508306267",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Wang, MD
• Christina Shy-Hwa Wang, PHARMD
• Christina Y. Wang, MD, MPH
• Chung Kun Wang, DDS
• Claudia Wang, DDS
• Connie Wei-Lie Wang
• Da-Gang Wang, DAOM, L.AC.
• David Enze Wang, MD
• Diana J Wang
• Doris D Wang, M.D., PH.D

• General Practice Dentistry in San Francisco, CA
• Providers in San Francisco, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.