Active NPI
David Mingxi Li
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Jose, CA
National Provider Identifier
1104379718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 103082
- Practice address
- 5150 Graves Ave Ste 12G
San Jose, CA 95129-5015 - Phone
- (408) 255-8545
- NPI assigned
- Jul 31, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7356 | NV | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 103082 | CA | Primary |
Addresses
Primary practice location
5150 Graves Ave Ste 12G
San Jose, CA 95129-5015
Mailing address
5526 Bigoak Dr
San Jose, CA 95129-3107
Other practice location 1
2626 Mission St
San Francisco, CA 94110-3102
Phone (415) 285-9847
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7356 | NV | MD | Dentist |
| 103082 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David M Li DDS Ms Inc | Orthodontics and Dentofacial Orthopedics | Current | Accepting new patients |
Locations
5150 Graves Ave
Ste 12G
San Jose, CA 95129
Phone (408) 255-8545
Organizations & group practices 1
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Jose, CA
- NPI 1912688755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1104379718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5526 BIGOAK DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951293107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 GRAVES AVE STE 12G",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951295015",
"telephone_number": "408-255-8545"
}
],
"practiceLocations": [
{
"address_1": "2626 Mission St",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941103102",
"country_code": "US",
"telephone_number": "415-285-9847",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LI",
"first_name": "DAVID",
"middle_name": "MINGXI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-31",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "7356",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "103082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.