Provider Demographics
NPI:1114004678
Name:WANG, SHUFEI (DDS)
Entity Type:Individual
Prefix:
First Name:SHUFEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 TELEGRAPH RD
Mailing Address - Street 2:BLDG. B
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-1716
Mailing Address - Country:US
Mailing Address - Phone:248-647-8656
Mailing Address - Fax:248-647-0402
Practice Address - Street 1:6405 TELEGRAPH RD
Practice Address - Street 2:BLDG. B
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-1716
Practice Address - Country:US
Practice Address - Phone:248-647-8656
Practice Address - Fax:248-647-0402
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010155591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry