Provider Demographics
NPI:1881189736
Name:WANG, ALLAN YUANSHAN (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:YUANSHAN
Last Name:WANG
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2036
Mailing Address - Country:US
Mailing Address - Phone:925-947-1188
Mailing Address - Fax:
Practice Address - Street 1:2710 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2036
Practice Address - Country:US
Practice Address - Phone:925-947-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1025041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty