Provider Demographics
NPI:1235902214
Name:JONATHAN Z WANG DDS PLLC
Entity Type:Organization
Organization Name:JONATHAN Z WANG DDS PLLC
Other - Org Name:ASHEVILLE DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-691-1005
Mailing Address - Street 1:4 SMILE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2065
Mailing Address - Country:US
Mailing Address - Phone:828-252-0111
Mailing Address - Fax:
Practice Address - Street 1:4 SMILE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2065
Practice Address - Country:US
Practice Address - Phone:828-252-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JONATHAN Z WANG DDS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-01
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty