Healthcare Provider Details

I. General information

NPI: 1891282851
Provider Name (Legal Business Name): TINGXI WU DDS, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 MAIN ST
NASHUA NH
03060-2725
US

IV. Provider business mailing address

151 MAIN ST
NASHUA NH
03060-2725
US

V. Phone/Fax

Practice location:
  • Phone: 603-886-0000
  • Fax:
Mailing address:
  • Phone: 603-886-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDF11749
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number33798
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number05075
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: