Individual provider Active NPI

Jer-Wei Chiang, D.D.S

  • Dentist
  • Flushing, NY
National Provider Identifier
1639465784
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
057638 Issued in NY
Practice address
13702 Northern Blvd
Apt 6C
Flushing, NY 11354-4322
Phone
(310) 500-9822
NPI assigned
Jun 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Dentist 122300000X 057638 NY Primary

Addresses

Primary practice location

13702 Northern Blvd
Apt 6C
Flushing, NY 11354-4322

Mailing address

13702 Northern Blvd
Apt 6C
Flushing, NY 11354-4322

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

State licenses

LicenseStateTypeSpecialty
057638NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1639465784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13702 NORTHERN BLVD",
            "address_2": "APT 6C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13702 NORTHERN BLVD",
            "address_2": "APT 6C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544322",
            "telephone_number": "310-500-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "JER-WEI",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.