Individual provider Active NPI

Jianqiang Xiao, DMD

  • General Practice Dentistry
  • Fanwood, NJ
National Provider Identifier
1447713524
Registry record updated May 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02784400 Issued in NJ
Practice address
346 South Ave Ste 7
Fanwood, NJ 07023-1356
Phone
(908) 889-2020
Fax
(908) 889-8411
NPI assigned
Apr 7, 2019
Last updated
May 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02784400 NJ
General Practice Dentistry 1223G0001X 22DI02784400 NJ Primary

Addresses

Primary practice location

346 South Ave Ste 7
Fanwood, NJ 07023-1356

Mailing address

346 South Ave Ste 7
Fanwood, NJ 07023-1356
Phone (908) 889-2020

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
22DI02784400NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yogi Dental Center General Practice PastSince Sep 1, 2020 Accepting new patients
Barry N. Eisenman, DMD, LLC PastSince Sep 1, 2021 Accepting new patients
Domenic Monaco D.M.D., P.a. General Practice PastSince May 22, 2022 Accepting new patients

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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652572800000",
    "number": "1447713524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 SOUTH AVE STE 7",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231356",
            "telephone_number": "908-889-2020",
            "fax_number": "908-889-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 SOUTH AVE STE 7",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231356",
            "telephone_number": "908-889-2020",
            "fax_number": "908-889-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIAO",
        "first_name": "JIANQIANG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-07",
        "last_updated": "2022-05-15",
        "certification_date": "2022-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02784400",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02784400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fanwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2022; 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.