Active NPI
Gene Jason Wang, D.M.D.
- General Practice Dentistry
- Issaquah, WA
National Provider Identifier
1871033316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE60861731
- Practice address
- 3707 Providence Point Dr SE Ste E
Issaquah, WA 98029-6216 - Phone
- (425) 391-1331
- NPI assigned
- Mar 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE60861731 | WA | Primary |
Addresses
Primary practice location
3707 Providence Point Dr SE Ste E
Issaquah, WA 98029-6216
Mailing address
125 Steinbright Dr
Collegeville, PA 19426-4010
Phone (484) 868-7724
Other practice location 1
1202 Martin Luther King Jr Way
Tacoma, WA 98405-3926
Phone (253) 441-4743
Other practice location 2
3609 S 19th St
Tacoma, WA 98405-1918
Phone (253) 573-0070
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE60861731 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dkeidek, Fernyhough, Gile, Hagel, Nov & Quickstad PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Issaquah, WA
- NPI 1891652038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545436800000",
"number": "1871033316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 STEINBRIGHT DR",
"city": "COLLEGEVILLE",
"state": "PA",
"postal_code": "194264010",
"telephone_number": "484-868-7724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3707 PROVIDENCE POINT DR SE STE E",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980296216",
"telephone_number": "425-391-1331"
}
],
"practiceLocations": [
{
"address_1": "1202 Martin Luther King Jr Way",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984053926",
"country_code": "US",
"telephone_number": "253-441-4743",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3609 S 19th St",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984051918",
"country_code": "US",
"telephone_number": "253-573-0070",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WANG",
"first_name": "GENE",
"middle_name": "JASON",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-02",
"last_updated": "2018-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE60861731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.