Hongbo Xu, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54458 Issued in CA

Practice address

3011 Santa Monica Blvd
Santa Monica, CA 90404-2555

Phone

(310) 709-5687

Fax

(310) 828-7383

NPI assigned

May 20, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hongbo Xu D.D.S.

  • General Practice Dentistry
  • Santa Monica, CA
  • NPI 1619313301
  NPD (past) Authorized official
• Dr.Charles C Jeng/Dr.Martha Z Yan

  • Dentist
  • Santa Monica, CA
  • NPI 1437305455
  NPD (past)

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1104051010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042555",
            "telephone_number": "310-709-5687",
            "fax_number": "310-828-7383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042555",
            "telephone_number": "310-709-5687",
            "fax_number": "310-828-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "HONGBO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-20",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wenchao Wu, M.D.
• Winnie Wu, MD
• Rikelle Wussow, NP
• Pamela Wyatt
• Danny Xia Nan Xu, MD
• Jennifer Wenjing Xu, MD
• Shirley Xiaomei Xu, MD
• Aikaterini Kathy Xydis
• Xyz Health Inc
• Leda Yacoubian

• General Practice Dentistry in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.