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General NPI Number Information
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NPI Number | 1407464423
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Entity Type | Individual
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Provider Name | PING WANG
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 28318 DUPONT BLVD
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City | MILLSBORO
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State | DE
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Zip | 19966-4774
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Country | US
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Telephone | 302-934-8005
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Fax |
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Provider Business Mailing Address
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Address Line | 13226 HUNT RDG
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-1153
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Country | US
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Telephone | 443-676-6088
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16960
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS042707
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | G1-0011526
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License Number State | DE
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