Healthcare Provider Details

I. General information

NPI: 1114811940
Provider Name (Legal Business Name): YIOU WANG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2A MYRTLE DR
MONTAGUE NJ
07827-3059
US

IV. Provider business mailing address

11-21 UPPER POND RD APT 106B
PARSIAPPANY NJ
07054
US

V. Phone/Fax

Practice location:
  • Phone: 973-293-3404
  • Fax:
Mailing address:
  • Phone: 701-566-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03130900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: