John Wang, DDS
Individual provider Active NPI General Practice Dentistry · Teecnospos, AZ
NPI 1881997682 · NPPES record last updated Aug 17, 2021
Key facts
- NPI
- 1881997682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 60057 (CA)
- Practice address
- US Hwy 160 & Navajo Route 35 - Red Mesa
Teecnospos, AZ 86514 - Phone
- (928) 656-5000
- NPI assigned
- Dec 16, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60057 | CA | MD | General Practice Dentistry |
Interoperability endpoints
- john.wang@srsu.directihs.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60057 | CA | Yes |
Addresses
Primary practice location
US Hwy 160 & Navajo Route 35 - Red Mesa
Teecnospos, AZ 86514
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (928) 656-5000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | John.Wang@SRSU.directihs.net | Direct |
Other providers in Teecnospos, AZ
- Nuanphan S Poole
- Mary Melissa Rigg
- Ralph Henry Smith Jr.
- Richard A Stimson
- Evelyn Todacheene
- Richard Hugh Ward
- Surrina Whitehorse
- Ramona Francine Yazzie
- Norman J. Yellowhair
All providers in Teecnospos, AZ · General Practice Dentistry in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.