Longqian Wang

Primary specialty

DentistTaxonomy code 122300000X

License

12818 Issued in CT

Practice address

49 Pershing Dr
Derby, CT 06418-1406

Phone

(203) 732-4300

NPI assigned

Sep 8, 2020

Last updated

Sep 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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.

• 260 Main St Portland Inc

  • Dental Clinic/Center
  • Portland, CT
  • NPI 1659946085
  NPD Authorized official
• 3885 Main St Bridgeport Dental Inc

  dba Connecticut Family Dental

  • General Practice Dentistry
  • Bridgeport, CT
  • NPI 1831771450
  NPD Authorized official

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1669086575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 POST RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 PERSHING DR",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181406",
            "telephone_number": "203-732-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LONGQIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "12818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Wain, MD
• Wal-Mart Stores East, LP (Vision Center 30-2896)
• Jackson Riley Waldrip, DO
• Lindsay Walker
• Joyce C Wamsele, M.D
• Muhammad Waqar, M.D.
• Robert James Wasnick, M.D.
• Linda A Weisheit, RPH
• Ryan Edward Weiss, PA-C
• Emily Jean Wengertsman, MS, LPC

• Dentist in Derby, CT
• Providers in Derby, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.