MEDICARE: KE WANG ORTHODONTICS 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1538016803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KE WANG ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	11800 REINDEER DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754-6137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9951 ANDERSON MILL RD STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-2280
Country	:	US
Telephone Number	:	214-228-1572
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KE WANG
Credential	:
Telephone Number	:	214-228-1572

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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