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NPI Code Detail

MEDICARE: XUE YU SHEN DMD

MEDICARE:   XUE YU  SHEN  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)21007MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1X09042OTHERBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245249820
Entity Type Code : Individual
Provider Name (Legal Business Name) : XUE YU SHEN DMD
Provider Business Mailing Address
First Line : 9 LINDEN STREET
Second Line :
City : WORCESTER
State : MA
Zip : 01609
Country : US
Telephone Number : 508-755-0008
Fax Number : 508-770-0603
Provider Business Practice Location Address
First Line : 9 LINDEN STREET
Second Line :
City : WORCESTER
State : MA
Zip : 01609
Country : US
Telephone Number : 508-755-0008
Fax Number : 508-770-0603
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 07/23/2012

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Directions to “ XUE YU SHEN DMD” Practice Location

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