MEDICARE: FELIX WANGSAWIHARDJA, DMD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1205775566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELIX WANGSAWIHARDJA, DMD, PLLC

Provider Business Mailing Address
First Line	:	8335 WALNUT HILL LN STE 205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4270
Country	:	US
Telephone Number	:	214-369-7664
Fax Number	:

Provider Business Practice Location Address
First Line	:	8335 WALNUT HILL LN STE 205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4270
Country	:	US
Telephone Number	:	214-369-7664
Fax Number	:

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. FELIX WANGSAWIHARDJA
Credential	:	DMD
Telephone Number	:	650-773-9359

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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