Ke Wang, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS111173 Issued in CA

Practice address

12395 El Camino Real Ste 213
San Diego, CA 92130-3084

Phone

(734) 972-5765

NPI assigned

May 30, 2018

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• D2 Dental of Michigan

  • General Practice Dentistry
  • Jackson, MI
  • NPI 1821420043
  NPD (past)
• Pro Dental Mi 1 PC

  • General Practice Dentistry
  • Jackson, MI
  • NPI 1437986700
  NPD (past)

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1730671306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5127 PEARLMAN WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303715",
            "telephone_number": "734-972-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL STE 213",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303084",
            "telephone_number": "734-972-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "KE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS111173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Byungho Wang, PHARMD
• Jonathan C Wang, M.D.
• Joslin Wang
• Justin Dejia Wang
• Kailun Wang
• Kevin Wang, MD
• Kyler Wang
• Lei Wang, M.D.
• Liang Wang
• Lilia 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 Feb 8, 2025; 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.