Individual provider Active NPI

Xiaoying Gu, D.M.D.

  • General Practice Dentistry
  • Stone Mountain, GA
National Provider Identifier
1780137679
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015561 Issued in GA
Practice address
1227 Rockbridge Rd Ste 300
Stone Mountain, GA 30087-3065
Phone
(256) 724-1237
NPI assigned
Jul 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10354 TN
General Practice Dentistry 1223G0001X DN015561 GA Primary

Addresses

Primary practice location

1227 Rockbridge Rd Ste 300
Stone Mountain, GA 30087-3065

Mailing address

1227 Rockbridge Rd Ste 300
Stone Mountain, GA 30087-3065
Phone (256) 724-1237

Other practice location 1

4335 Keith St NW
Cleveland, TN 37312-4818
Phone (423) 529-0382

Other practice location 2

455 Grayson Hwy Ste 4B
Lawrenceville, GA 30046-7102
Phone (770) 963-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180622002034 GA Order and Referring Only - DentistPractitioner - Dentist 9234484841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN015561GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1780137679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 ROCKBRIDGE RD STE 300",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873065",
            "telephone_number": "256-724-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 ROCKBRIDGE RD STE 300",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873065",
            "telephone_number": "256-724-1237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4335 Keith St NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373124818",
            "country_code": "US",
            "telephone_number": "423-529-0382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Grayson Hwy Ste 4B",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467102",
            "country_code": "US",
            "telephone_number": "770-963-5999",
            "fax_number": "770-963-6603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GU",
        "first_name": "XIAOYING",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10354",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.