Individual provider Active NPI

Wenjing Pang

  • Dentist
  • Mebane, NC
National Provider Identifier
1942824222
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11786 Issued in NC
Practice address
1242 S Fifth St Ste D
Mebane, NC 27302-9756
Phone
(919) 304-1666
NPI assigned
Jun 3, 2020
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11786 NC Primary

Addresses

Primary practice location

1242 S Fifth St Ste D
Mebane, NC 27302-9756

Mailing address

503 Sutter Gate LN
Morrisville, NC 27560-7260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200717000883 NC Order and Referring Only - DentistPractitioner - Dentist 2860816238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11786NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates Xxxi DDS PA CurrentSince Oct 23, 2022 Accepting new patients
Steven J Kim DDS and Wenjing Pang DDS PLLC CurrentSince Apr 28, 2024 Accepting new patients
Zhanying Guo DDS PA PastSince Jun 7, 2020 Accepting new patients

Locations

1242 S Fifth St
#D
Mebane, NC 27302
Phone (919) 304-1666

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1942824222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 SUTTER GATE LN",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275607260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 S FIFTH ST STE D",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029756",
            "telephone_number": "919-304-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "WENJING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mebane, NC

Sources for this page

Verify at the official NPI Registry.