DR. ICHUNG WANG (NPI# 1619027620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619027620 |
| Entity Type | Individual |
| Full Name | DR. ICHUNG WANG |
| Other Name | DR. JOHNNY WANG |
| Credential | DDS |
| Practice Address |
1959 Ne Pacific St Seattle WA 98195-7131 |
| Mailing Address |
Po Box 357131 Seattle WA 98195-7131 |
| Practice Telephone | 2066168794 |
| Mailing Telephone | 2066168794 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
CS10000417 | WA | Dental Providers |
| Street Address |
1959 NE PACIFIC ST |
| City | SEATTLE |
| State | WA |
| Zip Code | 98195-7131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637298 | Divis Kaur Khaira | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195 | 2005-05-23 |
| 1225639628 | Alexandra Christina Schenck | Speech-Language Pathologist | 1959 Ne Pacific St, 3rd Floor, Ne 300, Seattle, WA 98195 | 2020-11-03 |
| 1245831692 | Lindsey Marie Graff | Registered Nurse | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-11-03 |
| 1841891165 | Yip Han Lee | Nurse Anesthetist, Certified Registered | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-11-03 |
| 1003415316 | Thuy Duong Hoang Nguyen | Pharmacist | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-10-19 |
| 1982201968 | Timothy Shan | Pharmacist | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-10-03 |
| 1245847326 | Erika Patterson | Registered Nurse | 1959 Ne Pacific St, Seattle, WA 98195-5063 | 2020-09-23 |
| 1932716032 | Poonam Gill | Registered Nurse | 1959 Ne Pacific St, Seattle, WA 98195-7263 | 2020-09-23 |
| 1962018119 | Vivian Dao | Pharmacist | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-09-22 |
| 1558977843 | Angela Schwartz | Registered Nurse | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-09-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730700741 | Christian Van Rooyen | Student in an Organized Health Care Education/Training Program | 1951 Pacific Street, Seattle, WA 98195 | 2020-04-30 |
| 1720608235 | Alexander John Arnold | Psychiatry & Neurology | 1959 Ne Pacific St, Rr650, Seattle, WA 98195 | 2020-04-24 |
| 1588127138 | Scott Boop | Student in an Organized Health Care Education/Training Program | Department of Neurological Surgery, 1959 Ne Pacific St, Box Number 356470, Seattle, WA 98195 | 2019-04-10 |
| 1275093973 | Elizabeth Grace Knoff Floodeen | Oral & Maxillofacial Surgery | University of Washington Department of Surgery, 1959 Ne Pacific Street, Seattle, WA 98195 | 2019-03-20 |
| 1780174722 | Matias Eduardo Czerwonko Pupi | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific Street (university of Washington Depart, Seattle, WA 98195 | 2018-05-15 |
| 1235636143 | Caitlin Aiko Harrington | Student in an Organized Health Care Education/Training Program | University of Washington Internal Medicine Residency, Seattle, WA 98195 | 2018-04-07 |
| 1851897243 | Natalie Miller | Student in an Organized Health Care Education/Training Program | University of Washington Medical Center 1959 Ne Pacific, Seattle, WA 98195 | 2018-04-04 |
| 1386140978 | Elena Luisa Pellicer | Student in an Organized Health Care Education/Training Program | Univ of Washington Dept of Obgyn, 1959 Ne Pacific St., Seattle, WA 98195 | 2018-04-02 |
| 1407386824 | Sherry S Wang | Radiology | Uw Radiology, 1959 Ne Pacific Street, Box 357115, Seattle, WA 98195 | 2017-06-18 |
| 1932638137 | Maziar Riazy | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific Street, Rm Ne110, University of Washington Medical Center - Pathology, Seattle, WA 98195 | 2017-06-09 |
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| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225653397 | Rika Takada | Dentist | B403 Health Sciences Building, Seattle, WA 98195-0001 | 2020-06-14 |
| 1467074757 | Amit Srikant Gharpure | Dentist | 1959 Ne Pacific Street Health Science Center Room B-403, Seattle, WA 98195-0001 | 2020-05-10 |
| 1164890026 | Shih-chung Liao | Dentist | 720 Olive Way Ste 810, Seattle, WA 98101-1836 | 2015-09-09 |
| 1093147068 | Etheridge Family Dentistry | Dentist | 3130 E Madison St Ste 103, Seattle, WA 98112-4221 | 2013-08-01 |
| 1790036903 | Neal Christopher Raval | Dentist | 2801 1st Avenue, #509, Seattle, WA 98121 | 2012-09-27 |
| 1083971238 | Yung-ting Hsu | Dentist | 1959 Ne Pacific St # D-554, Seattle, WA 98195-7444 | 2012-04-12 |
| 1760760847 | Martin J. Campbell | Dentist | 2046 Westlake Ave N Ste 204, Seattle, WA 98109-2753 | 2011-07-24 |
| 1962739102 | David Au-yeung, Dmd., Pllc | Dentist | 2033 2nd Ave, #906, Seattle, WA 98121-2242 | 2009-11-09 |
| 1760465306 | Thomas Patrick Sweeney | Dentist | 701 5th Ave Ste 4660, Seattle, WA 98104-7057 | 2005-11-29 |
| 1326044058 | Er-jia Mao | Dentist | 2111 N Northgate Way, Ste 215, Seattle, WA 98133-9018 | 2005-06-27 |
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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.