Xiaoyu Ma

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028693 Issued in IL

Practice address

2241 Theodore St
Crest Hill, IL 60403-1881

Phone

(815) 741-1700

NPI assigned

Apr 26, 2010

Last updated

Dec 21, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1942527270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 THEODORE ST",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 THEODORE ST",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031881",
            "telephone_number": "815-741-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "XIAOYU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina A Leno, PT
• Margaret Ann Lewandowski, FNP
• Jerome Charles Lietz, OD
• Karina Lopez
• M. M. Ahsan S.C. (Dr. Ahsan and Associates)
• Kelli Majka
• Catherine Malooly, MPT
• Sirisha Mandadi, DDS
• Shwetha Manjunath, MD
• Jena L. Margis, CADC

• General Practice Dentistry in Crest Hill, IL
• Providers in Crest Hill, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.