Active NPI
Xuan Yu Mao, DDS
- Dentist
- San Leandro, CA
National Provider Identifier
1871377176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109114
- Practice address
- 1598 Washington Ave
San Leandro, CA 94577 - NPI assigned
- Aug 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 109114 | CA | Primary |
Addresses
Primary practice location
1598 Washington Ave
San Leandro, CA 94577
Mailing address
24 La Salle Dr
Moraga, CA 94556-1510
Phone (650) 255-2988
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
| License | State | Type | Specialty |
|---|---|---|---|
| 109114 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1871377176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 LA SALLE DR",
"city": "MORAGA",
"state": "CA",
"postal_code": "945561510",
"telephone_number": "650-255-2988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1598 WASHINGTON AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAO",
"first_name": "XUAN YU",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-21",
"last_updated": "2023-08-21",
"certification_date": "2023-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.