Derick Wang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

29793 Issued in TX

Practice address

1455 Austin Hwy
San Antonio, TX 78209-4455

Phone

(412) 897-0174

NPI assigned

Oct 8, 2010

Last updated

Jul 24, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Derick Wang DMD PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mountain View, CA
  • NPI 1487177036
  Authorized official Same address or phone

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1740590777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12803 WEST AVE",
            "address_2": "APT 19207",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782161813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 AUSTIN HWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094455",
            "telephone_number": "412-897-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "DERICK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-08",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038440",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Walz, M.D.
• Walzem Family Denttal (The Smile Center)
• Lilian Wambu
• Alan Wan, CNIM
• Aileen Wang, MD
• Eric Wang, CRNA, DNP
• Guan-Jie Wang, PHARM. D.
• Hongning Wang
• Howard T. Wang, M.D.
• Jay Ching-En Wang, DO, MS, MPH

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.