Organization Active NPI

Han and Xu Dental Corporation

  • General Practice Dentistry
  • Rosemead, CA
National Provider Identifier
1356717565
Registry record updated Dec 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59365 Issued in CA
Legal business name
HAN AND XU DENTAL CORPORATION
Practice address
2111 San Gabriel Blvd Ste I
Rosemead, CA 91770-3600
Phone
(626) 280-4976
NPI assigned
Aug 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2015

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

Authorized official

Name
Shaun Xun Xu, DDS, PHD
Title
Ceo
Phone
(626) 627-6249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 59365 CA Primary

Addresses

Primary practice location

2111 San Gabriel Blvd Ste I
Rosemead, CA 91770-3600

Mailing address

2111 San Gabriel Blvd Ste I
Rosemead, CA 91770-3600

Other names 1

  • JUN AND SHAN DENTAL SERVICE INC Former legal business name

National Provider Directory

National Provider Directory

Locations

2111 San Gabriel Blvd
Ste I
Rosemead, CA 91770
Phone (626) 280-4976

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450569600000",
    "number": "1356717565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 SAN GABRIEL BLVD STE I",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 SAN GABRIEL BLVD STE I",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703600",
            "telephone_number": "626-280-4976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAN AND XU DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-12-20",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "XUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-627-6249",
        "authorized_official_credential": "DDS, PHD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JUN AND SHAN DENTAL SERVICE INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rosemead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.