Individual provider Active NPI

Yixin Jiang

  • Dentist
  • Providence, RI
National Provider Identifier
1124819255
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN10000949 Issued in MA
Practice address
100 Mathewson St
Providence, RI 02903-1859
Phone
(617) 468-8210
NPI assigned
May 16, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN10000949 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

100 Mathewson St
Providence, RI 02903-1859

Mailing address

1 Kneeland St
Boston, MA 02111-1527

Other practice location 1

1 Kneeland St
Boston, MA 02111-1527
Phone (617) 468-8210

Other practice location 2

243 Elmwood Ave
Providence, RI 02907-1547
Phone (401) 409-4553

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
DN10000949MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1124819255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MATHEWSON ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031859",
            "telephone_number": "617-468-8210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kneeland St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111527",
            "country_code": "US",
            "telephone_number": "617-468-8210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "243 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029071547",
            "country_code": "US",
            "telephone_number": "401-409-4553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIANG",
        "first_name": "YIXIN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-05-16",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN10000949",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.