Fan Xu
Individual provider Active NPI General Practice Dentistry · Okanogan, WA
NPI 1447967641 · NPPES record last updated Jan 24, 2023
Key facts
- NPI
- 1447967641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE61354779 (WA)
- Practice address
- 626-2ND Ave S
Okanogan, WA 98840 - Phone
- (800) 660-2129
- NPI assigned
- Oct 28, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61354779 | WA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE61354779 | WA | Yes |
Addresses
Primary practice location
626-2ND Ave S
Okanogan, WA 98840
Mailing address
626 2ND Avenue South
P.O. Box 1340
Okanogan, WA 98840
Phone (800) 660-2129
Other practice location 1
3191 S Sepulveda Blvd Apt 308
Los Angeles, CA 90034-4208
Phone (929) 272-4056
Other providers in Okanogan, WA
- Amanda B Segars-Huffstetler
- Lue'Cinda R. Soriano-Churape
- Mary E Swayze
- Adrian Henoch Tomarere
- Webb and Loiseau, PLLC
- Beth Erin Zimmerman
All providers in Okanogan, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.