Healthcare Provider Details

I. General information

NPI: 1487414819
Provider Name (Legal Business Name): MONICA WANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 W EL CAMINO REAL STE 1
SUNNYVALE CA
94087-1180
US

IV. Provider business mailing address

703 MAIN ST
PATERSON NJ
07503-2621
US

V. Phone/Fax

Practice location:
  • Phone: 650-282-5555
  • Fax: 650-282-5051
Mailing address:
  • Phone: 973-754-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112493
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: