DEVON LIA-SOAN WAN (NPI# 1255666228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255666228 |
| Entity Type | Individual |
| Full Name | DEVON LIA-SOAN WAN |
| Credential | DMD |
| Practice Address |
1809 National Ave San Diego CA 92113-2113 |
| Mailing Address |
3512 Seahorn Cir. San Diego CA 92130 |
| Practice Telephone | 6195152394 |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
60547 | CA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5296 University Ave Ste 1, San Diego, CA 921052269 | 6192652262 |
| Street Address |
1809 NATIONAL AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92113-2113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184697559 | Said Raqib Sana | Emergency Medicine | 1809 National Ave, San Diego, CA 92113-2113 | 2006-02-08 |
| 1679191423 | Pamela Santana Castillo | Nutritionist | 1809 National Ave, San Diego, CA 92113-2113 | 2020-07-08 |
| 1750909792 | Melissa Favela-ayala | Nutritionist | 1809 National Ave, San Diego, CA 92113-2113 | 2020-07-07 |
| 1306474812 | Lorena Amparo Oropeza Oregel | Nutritionist | 1809 National Ave, San Diego, CA 92113-2113 | 2020-03-30 |
| 1568097707 | Margaux Bianca Mariano | Occupational Therapist | 1809 National Ave, San Diego, CA 92113-2113 | 2020-03-09 |
| 1528698057 | Anya Katzina Mancillas | Speech-Language Pathologist | 1809 National Ave, San Diego, CA 92113-2113 | 2020-01-23 |
| 1316584931 | Vanessa Nungaray Ruvalcaba | Nutritionist | 1809 National Ave, San Diego, CA 92113-2113 | 2019-12-02 |
| 1760028666 | Zakirah Hasan | Dietitian, Registered | 1809 National Ave, San Diego, CA 92113-2113 | 2019-11-26 |
| 1699311241 | Carla Sahian Rangel | Nutritionist | 1809 National Ave, San Diego, CA 92113-2113 | 2019-11-19 |
| 1497398077 | Georgina Parra | Dietitian, Registered | 1809 National Ave, San Diego, CA 92113-2113 | 2019-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609305986 | Cynthia Alba | Nutritionist | 1809 National Ave., San Diego, CA 92113 | 2017-06-08 |
| 1184153983 | Jessy Milligan | Counselor | 4125 Alpha Street, San Diego, CA 92113 | 2017-06-06 |
| 1730557406 | Deborah Mary Malloy | Counselor | Jary Barreto, 2865 Logan Avenue, San Diego, CA 92113 | 2015-09-10 |
| 1104220912 | Imhotep Mustaqeem | Counselor | 3336 Steel Street, San Diego, CA 92113 | 2014-10-22 |
| 1831507300 | Olga Vasileva | Student in an Organized Health Care Education/Training Program | 2865 Logan Avenue, San Diego, CA 92113 | 2014-07-29 |
| 1477961951 | Angelica Quezada | Counselor | 32510 Newton Avenue B103, San Diego, CA 92113 | 2014-07-28 |
| 1477986750 | Anita Pena | Licensed Vocational Nurse | 604 Olivewood Ter, San Diego, CA 92113 | 2013-08-09 |
| 1134459399 | Susana Cabada | Technician, Other | 4031 Marine View Ave., San Diego, CA 92113 | 2010-01-11 |
| 1669595609 | Maria Emilia Siller | Registered Nurse | 3177a Oceanview Blvd, San Diego, AL 92113 | 2007-04-06 |
| 1710009691 | Maria Engracia Siordia | Licensed Vocational Nurse | 3177a Ocean View Blvd, San Diego, CA 92113 | 2007-04-04 |
| Find all providers in zip 92113 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455181 | Julia Nguyen | Dentist | 9225 Mira Mesa Blvd Ste 218, San Diego, CA 92126-4811 | 2020-10-22 |
| 1831797489 | Lily Neskin | Dentist | 4454 Shorepointe Way, San Diego, CA 92130-8635 | 2020-10-15 |
| 1487251294 | Zeki Abdulaali | Dentist | 1501 India St Unit 607, San Diego, CA 92101-2449 | 2020-10-05 |
| 1629681895 | Elizabeth Rodriguez | Dentist | 14701 Via Bettona Ste 215, San Diego, CA 92127-4808 | 2020-08-27 |
| 1679183602 | Hayat Fahliogullari-smith | Dentist | 1281 9th Ave Unit 1309, San Diego, CA 92101-4655 | 2020-08-04 |
| 1235768631 | Virgnia Padua Mattson D.m.d. | Dentist | 11717 Bernardo Plaza Ct Ste 100, San Diego, CA 92128-2419 | 2020-04-07 |
| 1154956050 | Enbara Corporation | Dentist | 5189 Clairmont Mesa Blvd, San Diego, CA 92117 | 2020-03-11 |
| 1215568043 | Hage Dental Corporation | Dentist | 3365 Rosecrans St Ste C, San Diego, CA 92110-4256 | 2020-01-30 |
| 1275174310 | Yige Zhao Dental Corporation | Dentist | 9840 Carmel Mountain Rd, San Diego, CA 92129-2812 | 2019-09-30 |
| 1083255111 | Wayne David Gonzales | Dentist | 8031 Linda Vista Rd # 210, San Diego, CA 92111-5110 | 2019-09-30 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.