Individual provider Active NPI

Xiaoxu Zhu, DDS

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1457616492
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28079 Issued in TX
Practice address
3620 E Rosedale St
Fort Worth, TX 76105-2449
Phone
(817) 531-3500
NPI assigned
Jul 5, 2012
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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 28079 TX Primary

Addresses

Primary practice location

3620 E Rosedale St
Fort Worth, TX 76105-2449

Mailing address

5608 Bedford LN
The Colony, TX 75056-3784
Phone (573) 746-0091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161025000057 TX Order and Referring Only - DentistPractitioner - Dentist 3577841667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28079TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1457616492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 BEDFORD LN",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750563784",
            "telephone_number": "573-746-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 E ROSEDALE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761052449",
            "telephone_number": "817-531-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHU",
        "first_name": "XIAOXU",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.