Individual provider Active NPI

Yingqiao Mao, DDS

  • Dentist
  • Leo, IN
National Provider Identifier
1497596431
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12014440A Issued in IN
Practice address
13919 Amstutz Rd
Leo, IN 46765-9605
Phone
(260) 368-8908
NPI assigned
Jun 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12014440A IN Primary

Addresses

Primary practice location

13919 Amstutz Rd
Leo, IN 46765-9605

Mailing address

715 S Forest Ave Apt 510
Ann Arbor, MI 48104-3135
Phone (614) 558-5596

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
12014440AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1497596431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S FOREST AVE APT 510",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481043135",
            "telephone_number": "614-558-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13919 AMSTUTZ RD",
            "city": "LEO",
            "state": "IN",
            "postal_code": "467659605",
            "telephone_number": "260-368-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAO",
        "first_name": "YINGQIAO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014440A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.