Wilson Shuaiwen Jing, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

62950 Issued in CA

Practice address

43000 Midway Dr Marine Corp Recruiting Station BLDG 595
San Diego, CA 92140-4500

Phone

(619) 524-4009

NPI assigned

Jul 11, 2013

Last updated

Apr 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1518308105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 DURHAM RIDGE PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104862",
            "telephone_number": "601-750-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43000 MIDWAY DR MARINE CORP RECRUITING STATION BLDG 595",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921404500",
            "telephone_number": "619-524-4009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-6090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5565 Grossmont Center Dr Ste 459",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919423023",
            "country_code": "US",
            "telephone_number": "619-202-4749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JING",
        "first_name": "WILSON",
        "middle_name": "SHUAIWEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62950",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "62950",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "10983",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": "M12345678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuchao Jin, PA-C
• Jinadu Medical Group Inc. (Lincoln Medical Group)
• Anuja Vora Jindal, MD, MPH
• Rishi Jindal, MD
• Ling NMN Jing, D.O.
• George Vincent Jinks, PHARMD
• Michaelle Ruth Jinnette, M.A., LMFT
• Jemma Baoyu Jio
• Miriam Jirari, MPH, RDN, CPT
• Leena Marlean Jiron

• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.