Active NPI
Xiaoying Gu, D.M.D.
- General Practice Dentistry
- Stone Mountain, GA
National Provider Identifier
1780137679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015561
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180622002034 | GA | Order and Referring Only - Dentist | 9234484841 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN015561 | GA | MD | General 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.