Provider Demographics
NPI:1740917038
Name:WANG, XI (DDS)
Entity type:Individual
Prefix:DR
First Name:XI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2760
Mailing Address - Country:US
Mailing Address - Phone:646-318-0205
Mailing Address - Fax:
Practice Address - Street 1:1361 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2760
Practice Address - Country:US
Practice Address - Phone:732-381-8968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029220001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice