Healthcare Provider Details

I. General information

NPI: 1114836566
Provider Name (Legal Business Name): Q WANG ENDO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 N WATTERS RD # 150
ALLEN TX
75013-4914
US

IV. Provider business mailing address

504 N WATTERS RD # 150
ALLEN TX
75013-4914
US

V. Phone/Fax

Practice location:
  • Phone: 937-709-3088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: QIAN WANG
Title or Position: MANAGING MEMBER
Credential:
Phone: 937-709-3088