Active NPI
Elijah Chang Wang, M.S., D.D.S
- Orthodontics and Dentofacial Orthopedics Dentistry
- Garland, TX
National Provider Identifier
1568907426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 34593
- Practice address
- 5129 N Garland Ave
Garland, TX 75040-2725 - Phone
- (972) 276-5191
- NPI assigned
- Jan 3, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DEN.00203033 | CO | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 34593 | TX | Primary |
Addresses
Primary practice location
5129 N Garland Ave
Garland, TX 75040-2725
Mailing address
2725 Raspberry CT
Plano, TX 75074-2050
Phone (408) 386-9401
Other practice location 1
3300 E Broad St
Mansfield, TX 76063-5629
Phone (682) 518-5856
Other practice location 2
6202 W Park Blvd
Plano, TX 75093-6200
Phone (972) 403-7364
Other practice location 3
3485 W 10th St Ste C
Greeley, CO 80634-5368
Phone (970) 353-4746
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 |
|---|---|---|---|
| 34593 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| DEN.00203033 | CO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1568907426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 RASPBERRY CT",
"city": "PLANO",
"state": "TX",
"postal_code": "750742050",
"telephone_number": "408-386-9401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5129 N GARLAND AVE",
"city": "GARLAND",
"state": "TX",
"postal_code": "750402725",
"telephone_number": "972-276-5191"
}
],
"practiceLocations": [
{
"address_1": "3300 E Broad St",
"address_purpose": "LOCATION",
"city": "Mansfield",
"state": "TX",
"postal_code": "760635629",
"country_code": "US",
"telephone_number": "682-518-5856",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6202 W Park Blvd",
"address_purpose": "LOCATION",
"city": "Plano",
"state": "TX",
"postal_code": "750936200",
"country_code": "US",
"telephone_number": "972-403-7364",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3485 W 10th St Ste C",
"address_purpose": "LOCATION",
"city": "Greeley",
"state": "CO",
"postal_code": "806345368",
"country_code": "US",
"telephone_number": "970-353-4746",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WANG",
"first_name": "ELIJAH",
"middle_name": "CHANG",
"name_prefix": "Dr.",
"credential": "M.S., D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-03",
"last_updated": "2021-01-15",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CO",
"license": "DEN.00203033",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "34593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.