Individual provider Active NPI

Paj Vuam Dej Xiong

  • Pharmacist
  • Woodbury, MN
National Provider Identifier
1033944020
Registry record updated Sep 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
126666 Issued in MN
Practice address
449 Commerce Dr
Woodbury, MN 55125-4872
Phone
(651) 239-1875
NPI assigned
Sep 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 126666 MN Primary

Addresses

Primary practice location

449 Commerce Dr
Woodbury, MN 55125-4872

Mailing address

1482 Farrington St
Saint Paul, MN 55117-3612
Phone (651) 424-8128

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
126666MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1033944020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1482 FARRINGTON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551173612",
            "telephone_number": "651-424-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 COMMERCE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254872",
            "telephone_number": "651-239-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "PAJ VUAM DEJ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "126666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; 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.