=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285297143
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOYCE YUESHUO XU MD, DMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2019
-----------------------------------------------------
Last Update Date | 07/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1500 E MEDICAL CENTER DRIVE FLOOR 1, ROOM 1904, RECEPTION A
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48109-0312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-615-6095
-----------------------------------------------------
Fax | 734-764-3485
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1500 E MEDICAL CENTER DR G1218 TOWSLEY, SPC 5222
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48109-5222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-232-6048
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | 4301513576
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------