Individual provider Active NPI

Ruixiang Li Qin, DMD

  • Dentist
  • Oakland, CA
National Provider Identifier
1194230375
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS101792 Issued in CA
Practice address
933 Jackson St
Oakland, CA 94607-4809
Phone
(510) 839-1986
Fax
(510) 839-1985
NPI assigned
Dec 9, 2017
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS101792 CA Primary

Addresses

Primary practice location

933 Jackson St
Oakland, CA 94607-4809

Mailing address

933 Jackson St
Oakland, CA 94607-4809
Phone (510) 839-1986

Other names 1

  • Dr. Ruixiang Li Former name

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
DDS101792CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Li Qin Dental Practice Inc Current Accepting new patients
Dental Office of Ruixiang Li Qin DMD Inc. Current Accepting new patients
Ruixiang Li Qin DMD Inc Current Accepting new patients

Locations

933 Jackson St
Oakland, CA 94607
Phone (510) 839-1986

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1512777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1194230375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 JACKSON ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074809",
            "telephone_number": "510-839-1986",
            "fax_number": "510-839-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 JACKSON ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074809",
            "telephone_number": "510-839-1986",
            "fax_number": "510-839-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIN",
        "first_name": "RUIXIANG",
        "middle_name": "LI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-09",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS101792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUIXIANG",
            "last_name": "LI",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.