Provider Demographics
NPI:1184177255
Name:WANG, ANTHONY HONG HAN (DMD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:HONG HAN
Last Name:WANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:HU
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 ELMWOOD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3212
Mailing Address - Country:US
Mailing Address - Phone:949-293-5398
Mailing Address - Fax:
Practice Address - Street 1:9891 IRVINE CENTER DR STE 120
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4318
Practice Address - Country:US
Practice Address - Phone:949-943-3945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1003041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice