Individual provider Active NPI

Xin Li

  • Dentist
  • Conroe, TX
National Provider Identifier
1457911505
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37971 Issued in TX
Practice address
1336 League Line Rd Ste 400
Conroe, TX 77304-3457
Phone
(210) 790-2553
Fax
(936) 856-9970
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 37971 TX Primary

Addresses

Primary practice location

1336 League Line Rd Ste 400
Conroe, TX 77304-3457

Mailing address

3849 Juniper Meadows LN
Spring, TX 77386-4430
Phone (210) 790-2553

Other practice location 1

4849 Farm to Market Rd 1488
Suite 800
Magnolia, TX 77354
Phone (281) 971-2120

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
I20220301002358 TX Order and Referring Only - DentistPractitioner - Dentist 9133451149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37971TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Juniper Dental PLLC General Practice CurrentSince Oct 5, 2025 Accepting new patients

Locations

1336 League Line Rd
Ste 400
Conroe, TX 77304
Phone (210) 790-2553

Organizations & group practices 1

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1457911505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3849 JUNIPER MEADOWS LN",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864430",
            "telephone_number": "210-790-2553",
            "fax_number": "936-856-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 LEAGUE LINE RD STE 400",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043457",
            "telephone_number": "210-790-2553",
            "fax_number": "936-856-9970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4849 Farm to Market Rd 1488",
            "address_2": "Suite 800",
            "address_purpose": "LOCATION",
            "city": "Magnolia",
            "state": "TX",
            "postal_code": "77354",
            "country_code": "US",
            "telephone_number": "281-971-2120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "XIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "37971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.