Provider Demographics
NPI:1447565239
Name:WANG, NIPING (BDS, PHD)
Entity Type:Individual
Prefix:
First Name:NIPING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:BDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4463 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-5306
Mailing Address - Country:US
Mailing Address - Phone:601-519-0557
Mailing Address - Fax:
Practice Address - Street 1:1090 NORTHCHASE PKWY SE
Practice Address - Street 2:SUITE 290
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-6405
Practice Address - Country:US
Practice Address - Phone:678-904-5665
Practice Address - Fax:678-247-7862
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3664-12122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist