Individual provider Active NPI

Lele Wang, DDS

  • General Practice Dentistry
  • Riverside, CA
National Provider Identifier
1639230733
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52789 Issued in CA
Practice address
8856 Arlington Ave
Riverside, CA 92503-1365
Phone
(951) 710-3970
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 52789 CA Primary

Addresses

Primary practice location

8856 Arlington Ave
Riverside, CA 92503-1365

Mailing address

23820 Gold Nugget Ave
Diamond Bar, CA 91765-2339
Phone (909) 861-0850

Other practice location 1

530 S Main St
Orange, CA 92868-4525
Phone (714) 571-3682

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210803001623 CA Order and Referring Only - DentistPractitioner - Dentist 3173927894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52789CAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: lwang@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1639230733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23820 GOLD NUGGET AVE",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652339",
            "telephone_number": "909-861-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8856 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925031365",
            "telephone_number": "951-710-3970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 S Main St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684525",
            "country_code": "US",
            "telephone_number": "714-571-3682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "LELE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.