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General NPI Number Information
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NPI Number | 1346777208
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Entity Type | Individual
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Provider Name | VICTOR YING WANG DMD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 67 MONTVALE AVE STE 101
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City | STONEHAM
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State | MA
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Zip | 02180-3618
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Country | US
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Telephone | 781-279-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 169 MONSIGNOR OBRIEN HWY APT 705
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City | CAMBRIDGE
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State | MA
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Zip | 02141-1261
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Country | US
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Telephone | 781-460-3815
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI02864600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 12534
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN1859441
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License Number State | MA
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