Bo Wang, DDS, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

22DI02634500 Issued in NJ

Practice address

281 Witherspoon St Ste 210
Princeton, NJ 08540-3228

Phone

(609) 288-2855

Fax

(609) 800-8500

NPI assigned

May 5, 2010

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 30, 2022 through Sep 30, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1962720623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 WITHERSPOON ST STE 210",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403228",
            "telephone_number": "609-288-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 WITHERSPOON ST STE 210",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403228",
            "telephone_number": "609-288-2855",
            "fax_number": "609-800-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "BO",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02634500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian J Wallace, PA
• Anne Batterberry Walsh
• Beata Walters, APN
• Elizabeth J Walters, CNM
• Courtney Wance
• Ivana Wang, M.S. CCC-SLP
• Warby Parker Inc.
• Warby Parker Inc.
• Susan Warchaizer, MD
• Kate Bachus Ware, LCSW

• Oral & Maxillofacial Surgery (D.M.D.) in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.