Yizu Jiao, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12801 Issued in NC

Practice address

100 N 10TH St
Erwin, NC 28339-1802

Phone

(734) 277-1908

NPI assigned

Jun 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1902537384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S CAMELLIA ST",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275166076",
            "telephone_number": "734-277-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N 10TH ST",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283391802",
            "telephone_number": "734-277-1908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 NC-55 West",
            "address_purpose": "LOCATION",
            "city": "Mt Olive",
            "state": "NC",
            "postal_code": "28365",
            "country_code": "US",
            "telephone_number": "734-277-1908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIAO",
        "first_name": "YIZU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-06-17",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Aguilera Herrera, LCSW-A
• Todd Lynn Hold, MD
• Hope Inside Mobile Testing
• Ryquaisa Kyella Humphrey, LCASA, LCSWA
• Ashley A Irons, FNP
• Melissa Ann Johnson, PHARMD
• MD Abu Zahed Karim, M.D.
• Alison Moore Keene, MA
• Malik Kersey, MA, LPA
• Alyssa Lafave, PA-C

• General Practice Dentistry in Erwin, NC
• Providers in Erwin, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.

Verify at the official NPI Registry.