Individual provider Active NPI

Haifeng Xu, DDS, PHD

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1962763169
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12012273A Issued in IN
Practice address
828 Fort Wayne Ave
Indianapolis, IN 46204-1309
Phone
(317) 602-4898
NPI assigned
Jun 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12012273A IN Primary

Addresses

Primary practice location

828 Fort Wayne Ave
Indianapolis, IN 46204-1309

Mailing address

14536 Stonegate CT
Carmel, IN 46032-9132
Phone (317) 771-3303

Other practice location 1

9290 Waldemar Rd
Indianapolis, IN 46268-1132
Phone (317) 602-4898

Other practice location 2

29 E McCarty St
Ste 200
Indianapolis, IN 46225-3326
Phone (317) 602-4898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20160224002655 IN Order and Referring Only - DentistPractitioner - Dentist 3375848682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
12012273AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Friendly Womens Healthcare LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1962763169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14536 STONEGATE CT",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460329132",
            "telephone_number": "317-771-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 FORT WAYNE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041309",
            "telephone_number": "317-602-4898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9290 Waldemar Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462681132",
            "country_code": "US",
            "telephone_number": "317-602-4898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 E MCCARTY ST",
            "address_2": "STE 200",
            "address_purpose": "LOCATION",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462253326",
            "country_code": "US",
            "telephone_number": "317-602-4898",
            "fax_number": "317-559-7159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "XU",
        "first_name": "HAIFENG",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012273A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.