Jonathan Wang, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DDS108810 Issued in CA

Practice address

580 N Sunrise Ave Ste 190
Roseville, CA 95661-2890

Phone

(916) 772-0112

NPI assigned

Sep 25, 2023

Sex

Male

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.

• Dean N. Ahmad DDS Inc.

  • Dental Clinic/Center
  • Roseville, CA
  • NPI 1245891829
  NPD (past)
• Tinou T. Roncone, DDS, Ms, Apc

  • Periodontics
  • Temecula, CA
  • NPI 1912544370
  NPD (past)

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1881473411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 KENDALL DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 N SUNRISE AVE STE 190",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612890",
            "telephone_number": "916-772-0112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 W 34th St # 102",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900892710",
            "country_code": "US",
            "telephone_number": "213-740-5006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31493 Rancho Pueblo Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925924833",
            "country_code": "US",
            "telephone_number": "951-302-6385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "DDS108810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ella Walzer
• Rhonda Leah Wampler, MFT
• Richard Kurtis Wampler
• David Bennett Wampold, MD
• Sam Wan, ACUPUNCTURIST
• Bret Paul Wangan, LCSW
• Warby Parker Inc.
• David Andrew Ward, PA-C
• Keith Edwin Ward, D.C.
• Laurel Aine Ward

• Periodontics in Roseville, CA
• Providers in Roseville, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.