NPIMap

Organization Active NPI

Kevin Xu D.D.S., M.S.,P.S., Inc.

  • General Practice Dentistry
  • Tacoma, WA
National Provider Identifier
1578823852
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6938 Issued in WA
Legal business name
KEVIN XU D.D.S., M.S.,P.S., INC.
Practice address
5038 Tacoma Mall Blvd
Ste. a
Tacoma, WA 98409-7103
Phone
(253) 473-2166
Fax
(253) 473-2167
NPI assigned
May 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Authorized official

Name
Dr. Kevin Xu, DDS
Title
Dentist/Owner
Phone
(253) 473-2166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6938 WA Primary

Addresses

Primary practice location

5038 Tacoma Mall Blvd
Ste. a
Tacoma, WA 98409-7103

Mailing address

5038 Tacoma Mall Blvd
Ste. a
Tacoma, WA 98409-7103
Phone (253) 473-2166

Other identifiers 2

IdentifierTypeStateIssuer
1821074527OtherWAINDIVIDUAL
1710957329OtherWAINDIVIDUAL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1578823852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5038 TACOMA MALL BLVD",
            "address_2": "STE. A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097103",
            "telephone_number": "253-473-2166",
            "fax_number": "253-473-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5038 TACOMA MALL BLVD",
            "address_2": "STE. A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097103",
            "telephone_number": "253-473-2166",
            "fax_number": "253-473-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN XU D.D.S., M.S.,P.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "253-473-2166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1821074527",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1710957329",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.