Provider Demographics
NPI:1346777208
Name:WANG, VICTOR YING (DMD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:YING
Last Name:WANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 MONSIGNOR OBRIEN HWY APT 705
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1261
Mailing Address - Country:US
Mailing Address - Phone:781-460-3815
Mailing Address - Fax:
Practice Address - Street 1:67 MONTVALE AVE STE 101
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3618
Practice Address - Country:US
Practice Address - Phone:781-279-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028646001223P0221X
CT12534390200000X
MADN18594411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program