Active NPI
Wanlan Xiao, DDS
- General Practice Dentistry
- Livermore, CA
National Provider Identifier
1962672642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- CA53890
- Practice address
- 39 S Livermore Ave
Suite 217
Livermore, CA 94550-3119 - Phone
- (925) 373-7311
- Fax
- (925) 373-7310
- NPI assigned
- Mar 10, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | CA53890 | CA | Primary |
Addresses
Primary practice location
39 S Livermore Ave
Suite 217
Livermore, CA 94550-3119
Mailing address
39 S Livermore Ave
Suite 217
Livermore, CA 94550-3119
Phone (925) 373-7311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20150930001498 | CA | Order and Referring Only - Dentist | 5193033835 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CA53890 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249430400000",
"number": "1962672642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 S LIVERMORE AVE",
"address_2": "SUITE 217",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945503119",
"telephone_number": "925-373-7311",
"fax_number": "925-373-7310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 S LIVERMORE AVE",
"address_2": "SUITE 217",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945503119",
"telephone_number": "925-373-7311",
"fax_number": "925-373-7310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "XIAO",
"first_name": "WANLAN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2009-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "CA53890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.