Jiann-Jang Wu, BMD, MS
Individual provider Active NPI Endodontics · Winter Park, FL
NPI 1831278290 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831278290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- DN0011535 (FL)
- Practice address
- 201 N Lakemont Ave
Suite 2400
Winter Park, FL 32792-3208 - Phone
- (407) 647-4773
- Fax
- (407) 647-4548
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190410000702 | FL | Order and Referring Only - Dentist |
8820339393 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN0011535 | FL | Yes |
Addresses
Primary practice location
201 N Lakemont Ave
Suite 2400
Winter Park, FL 32792-3208
Mailing address
201 N Lakemont Ave
Suite 2400
Winter Park, FL 32792-3208
Phone (407) 647-4773
Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.