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General NPI Number Information
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NPI Number | 1063021343
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Entity Type | Individual
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Provider Name | XIXI WU BDS,MS,PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 1201 N STONEWALL AVE # 524D
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1214
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Country | US
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Telephone | 405-259-6048
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 N STONEWALL AVE # 524D
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1214
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Country | US
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Telephone | 405-259-6048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 80-PERIODONTICS
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License Number State | OK
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