Healthcare Provider Details

I. General information

NPI: 1760350458
Provider Name (Legal Business Name): BELINDA JINGWEN XUE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2025
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8057 BREWERTON RD
CICERO NY
13039-9585
US

IV. Provider business mailing address

5401 ARNOLD AVE BLDG 88
MCCLELLAN CA
95652-1018
US

V. Phone/Fax

Practice location:
  • Phone: 315-698-0040
  • Fax:
Mailing address:
  • Phone: 916-333-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number065766
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number111990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: