Individual provider Active NPI

Anthony Raymond Wing, D.M.D.

  • Dentist
  • Houston, TX
National Provider Identifier
1790898740
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN010941 Issued in GA
Practice address
2002 Holcombe Blvd
580/160
Houston, TX 77030-4211
Phone
(713) 791-1414
Fax
(713) 794-7640
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN010941 GA Primary

Addresses

Primary practice location

2002 Holcombe Blvd
580/160
Houston, TX 77030-4211

Mailing address

2002 Holcombe Blvd
580/160
Houston, TX 77030-4211
Phone (713) 791-1414

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
DN010941GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790898740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 HOLCOMBE BLVD",
            "address_2": "580/160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304211",
            "telephone_number": "713-791-1414",
            "fax_number": "713-794-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HOLCOMBE BLVD",
            "address_2": "580/160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304211",
            "telephone_number": "713-791-1414",
            "fax_number": "713-794-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WING",
        "first_name": "ANTHONY",
        "middle_name": "RAYMOND",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN010941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.