Individual provider Active NPI

Bowen Xiao

  • Dentist
  • Victorville, CA
National Provider Identifier
1013729920
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111124 Issued in CA
Practice address
13792 Bear Valley Rd
Victorville, CA 92392-8713
Phone
(760) 245-2010
NPI assigned
Jan 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 111124 CA Primary

Addresses

Primary practice location

13792 Bear Valley Rd
Victorville, CA 92392-8713

Mailing address

13792 Bear Valley Rd
Victorville, CA 92392-8713
Phone (626) 271-0575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111124CAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1013729920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13792 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923928713",
            "telephone_number": "626-271-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13792 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923928713",
            "telephone_number": "760-245-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIAO",
        "first_name": "BOWEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.