Provider Demographics
NPI:1871784546
Name:WANG, LINGLI (DDS, MS, PHD)
Entity type:Individual
Prefix:DR
First Name:LINGLI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3115
Mailing Address - Country:US
Mailing Address - Phone:626-286-2728
Mailing Address - Fax:888-789-4368
Practice Address - Street 1:1100 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3115
Practice Address - Country:US
Practice Address - Phone:626-286-2728
Practice Address - Fax:888-789-4368
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55582122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist