Yi Xie, DDS
Individual provider Active NPI Dentist · Suamico, WI
NPI 1740176783 · NPPES record last updated Feb 25, 2026
Key facts
- NPI
- 1740176783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6001857-15 (WI)
- Practice address
- 2352 Lineville Rd Ste 112
Suamico, WI 54313-8863 - Phone
- (920) 471-4988
- NPI assigned
- Jun 16, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 111661 | CA | MD | Dentist |
| 6001857-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates LTD of Wisconsin | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6001857-15 | WI | Yes |
| Dentist | 122300000X | 111661 | CA |
Addresses
Primary practice location
2352 Lineville Rd Ste 112
Suamico, WI 54313-8863
Mailing address
105 W College Ave
Apt 501
Appleton, WI 54911
Phone (909) 918-7206
Other providers in Suamico, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2026. 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.