Su Fong David Wan, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

22550 Issued in TX

Practice address

1990 Post Oak Blvd Ste H
Houston, TX 77056-3844

Phone

(832) 659-0977

Fax

(832) 659-0071

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1962577593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 POST OAK BLVD STE H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770563844",
            "telephone_number": "832-659-0977",
            "fax_number": "832-659-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 POST OAK BLVD STE H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770563844",
            "telephone_number": "832-659-0977",
            "fax_number": "832-659-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "SU FONG",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22550",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "22550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Lynn Wampler, LMSW ACP
• Clifton Kamtong Wan, D.C.
• David Qiang Wan, M.D.
• Luxi Wan, MD
• Ping Wan, CRNA
• Summer Wan
• Zhou Wan, ACUPUNCTURIST
• Matthew A Wanat, PHARMD
• William Allen Wandell, PHD
• Michael W. Wandling, MD, MS

• Endodontics in Houston, TX
• Providers in Houston, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.