MEDICARE: DR. WENDER JIANG D.D.S, M.S.

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	14074	TX

General Provider Information

NPI Number	:	1346464047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDER JIANG D.D.S, M.S.

Provider Business Mailing Address
First Line	:	9630 CLAREWOOD DR. STE A-4
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036
Country	:	US
Telephone Number	:	713-774-1136
Fax Number	:	713-774-1544

Provider Business Practice Location Address
First Line	:	9630 CLAREWOOD DR STE A4
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-3535
Country	:	US
Telephone Number	:	713-774-1136
Fax Number	:	713-774-1544

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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