Provider Demographics
NPI:1437391075
Name:WANG, SUNG-WEN KEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNG-WEN
Middle Name:KEN
Last Name:WANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 FM 1960 RD W
Mailing Address - Street 2:SUITE B1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4519
Mailing Address - Country:US
Mailing Address - Phone:281-893-3255
Mailing Address - Fax:
Practice Address - Street 1:5020 FM 1960 RD W
Practice Address - Street 2:SUITE B1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4519
Practice Address - Country:US
Practice Address - Phone:281-893-3255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-28
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice