Provider Demographics
NPI:1891833273
Name:WANG, WEN SHENG
Entity type:Individual
Prefix:
First Name:WEN
Middle Name:SHENG
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 ALSTER AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-4818
Mailing Address - Country:US
Mailing Address - Phone:626-447-1465
Mailing Address - Fax:
Practice Address - Street 1:1725 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1003
Practice Address - Country:US
Practice Address - Phone:213-413-5151
Practice Address - Fax:213-413-7171
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA486781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice