Provider Demographics
NPI:1780051078
Name:WEI, NA (DMD)
Entity type:Individual
Prefix:DR
First Name:NA
Middle Name:
Last Name:WEI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2202
Mailing Address - Country:US
Mailing Address - Phone:614-806-5689
Mailing Address - Fax:
Practice Address - Street 1:88 HOLMES ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2431
Practice Address - Country:US
Practice Address - Phone:617-318-3200
Practice Address - Fax:617-457-6600
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18570061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice