Carolyn Wang, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106278 Issued in CA

Practice address

9831 Mira Mesa Blvd
San Diego, CA 92131-1005

Phone

(858) 536-5550

NPI assigned

Jun 24, 2021

Last updated

May 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lance Rygg Professional Dental Corporation

  dba Mission Valley Dentists

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1366701096
  NPD (past)

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1588233365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5375 WALNUT AVE UNIT 1036",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917087049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9831 MIRA MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311005",
            "telephone_number": "858-536-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Wyoming Street",
            "address_2": "Dept of Medical Education",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45409",
            "country_code": "US",
            "telephone_number": "937-208-2205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5638 Mission Center Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921084348",
            "country_code": "US",
            "telephone_number": "619-220-0159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8928 Gramercy Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921232330",
            "country_code": "US",
            "telephone_number": "513-307-1688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4428 Convoy St Ste 230",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921113761",
            "country_code": "US",
            "telephone_number": "855-228-2336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106278",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela C. Wang, M.D.
• Anita Kaiwei Wang, PHARMD
• Annie Wang
• Audrey Wang, DDS
• Ben Wang, L.AC., O.M.D.
• Carolyn Wang
• Cassandra Wang
• Christine M Wang, M.D.
• Cindy Wang, O.D.
• Claire Tienwey Wang

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 May 2, 2024; 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.