Individual provider Active NPI

Bing Elliot Xia, DDS

  • General Practice Dentistry
  • San Bruno, CA
National Provider Identifier
1386664035
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47827 Issued in CA
Practice address
931 San Bruno Ave W.
San Bruno, CA 94066-1057
Phone
(415) 986-2626
Fax
(415) 986-2770
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47827 CA Primary

Addresses

Primary practice location

931 San Bruno Ave W.
San Bruno, CA 94066-1057

Mailing address

931 San Bruno Ave W.
San Bruno, CA 94066-1057
Phone (415) 986-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805002127 CA Practitioner - Dentist 0648652727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bing Elliot Xia DDS Inc CurrentSince Aug 3, 2020 Accepting new patients
Axia Dental Cooperation Current Accepting new patients

Locations

931 San Bruno Ave W
Rm 8
San Bruno, CA 94066
Phone (415) 986-2626

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1386664035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 SAN BRUNO AVE W.",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940661057",
            "telephone_number": "415-986-2626",
            "fax_number": "415-986-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 SAN BRUNO AVE W.",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940661057",
            "telephone_number": "415-986-2626",
            "fax_number": "415-986-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIA",
        "first_name": "BING",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bruno, CA

Sources for this page

Verify at the official NPI Registry.