Healthcare Provider Details

I. General information

NPI: 1760312664
Provider Name (Legal Business Name): CHRISTOPHER XIAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N BROADWAY ST
UNION CITY MI
49094-1100
US

IV. Provider business mailing address

3712 KNOLLWOOD CIR
ANN ARBOR MI
48108-9589
US

V. Phone/Fax

Practice location:
  • Phone: 517-741-4565
  • Fax:
Mailing address:
  • Phone: 412-266-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901603074
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: