Victoria M Wan, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE00010495 Issued in WA

Practice address

16400 Southcenter Pkwy
Suite 103
Tukwila, WA 98188-3335

Phone

(206) 575-0400

Fax

(206) 575-6469

NPI assigned

Nov 16, 2006

Sex

Female

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)

Not 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.

• Nurani, Mitchell, Kim, PC

  • Dentist
  • Tukwila, WA
  • NPI 1518302272
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871666883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 SOUTHCENTER PKWY",
            "address_2": "SUITE 103",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883335",
            "telephone_number": "206-575-0400",
            "fax_number": "206-575-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 SOUTHCENTER PKWY",
            "address_2": "SUITE 103",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883335",
            "telephone_number": "206-575-0400",
            "fax_number": "206-575-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "VICTORIA",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE00010495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Walters, MSW
• Jerome Walters Sr., CDP
• Harrison Wamai, DDS
• Maria Wamansjah, PHARMACIST
• Jonathan Alan Wan, D.C
• Shirley S. Wang, O.D.
• Stacey Wang
• Xiaojue Wang, PHARM D
• Hope Wanjiru
• Warby Parker Inc.

• Orthodontics and Dentofacial Orthopedics Dentistry in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• 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.