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NPI Code Detail

MEDICARE: JING XU DDS

MEDICARE:   JING  XU  DDS
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
11223G0001XGeneral Practice Dentistry56801CA

General Provider Information

NPI Number : 1770695447
Entity Type Code : Individual
Provider Name (Legal Business Name) : JING XU DDS
Provider Business Mailing Address
First Line : 1062 E LAS TUNAS DR
Second Line :
City : SAN GABRIEL
State : CA
Zip : 91776-1633
Country : US
Telephone Number : 626-282-2068
Fax Number : 626-293-8819
Provider Business Practice Location Address
First Line : 1062 E LAS TUNAS DR
Second Line :
City : SAN GABRIEL
State : CA
Zip : 91776-1633
Country : US
Telephone Number : 626-282-2068
Fax Number : 626-293-8819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 08/16/2021

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Directions to “ JING XU DDS” Practice Location

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