Yudong Xu, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019026810 Issued in IL

Practice address

303 W Springfield Ave
Champaign, IL 61820-4817

Phone

(217) 356-3335

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1245229822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 MULLIKIN DR",
            "address_2": "APT 204",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618228307",
            "telephone_number": "217-364-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W SPRINGFIELD AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204817",
            "telephone_number": "217-356-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "YUDONG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9178971",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marley Wright
• Susan Wright, RBT
• Catherine Ann Wrigley, MB BCH BAO
• Jian Xin Xie, PHARMD
• Yang Xu, LPC
• Lucy Yager
• Martha Margaret Yallaly, D.M.D.
• Tina Yi-Ting Yang, D.O.
• Hamid Yaqoob, M.D.
• Alex A Yarbrough, D.O.

• General Practice Dentistry in Champaign, IL
• Providers in Champaign, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.