Benjamin Wang, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DD5691 Issued in NM

Practice address

2050A 2ND St SE
Kirtland Afb, NM 87117-5522

Phone

(505) 846-3200

NPI assigned

May 13, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Locations

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

• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627
  Medicare reassignment NPD
• Unm Medical Group, Inc.

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1679139877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050A 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871175522",
            "telephone_number": "505-846-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "address_2": "ATTN: 59 MDW/SGHC",
            "address_purpose": "LOCATION",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "country_code": "US",
            "telephone_number": "210-292-6225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "BENJAMIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD5691",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "933 Bradbury Dr SE Ste 2222",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brooke Taylor, PHARMD
• Karen Christine Truesdell-Bierman, PHD
• Leticia R Turner, O.T.D.
• Stacey Renee Vierra, PA-C
• Patrick Walsh, MD
• Austin G Watson, IDMT
• Barry J Whetstone Jr.
• Seth R Williams, DNP
• George Eric Womble, REGISTERED NURSE
• Brendin Wood, PT, DPT

• Dentist in Kirtland Afb, NM
• Providers in Kirtland Afb, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.