Active NPI
Shuang Xu, DDS
- Pediatric Dentistry
- New York, NY
National Provider Identifier
1427369289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 055788
- Practice address
- 50 W34Th St 22C4
New York, NY 10001 - Phone
- (917) 291-0210
- NPI assigned
- Jun 27, 2010
- Last updated
- Jun 18, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 055788 | NY | Primary |
Addresses
Primary practice location
50 W34Th St 22C4
New York, NY 10001
Mailing address
50 W34Th St 22C4
New York, NY 10001
Phone (917) 291-0210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160315002384 | NY | Order and Referring Only - Dentist | 4880990910 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371513600000",
"number": "1427369289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 W34TH ST 22C4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10001",
"telephone_number": "917-291-0210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 W34TH ST 22C4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10001",
"telephone_number": "917-291-0210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "XU",
"first_name": "SHUANG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-27",
"last_updated": "2013-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "055788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.