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General NPI Number Information
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NPI Number | 1942994090
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Entity Type | Individual
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Provider Name | NICK XIE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 04/21/2024
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Provider Practice Location Address
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Address Line | 2640 SALEM AVE
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City | DAYTON
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State | OH
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Zip | 45406-2931
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Country | US
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Telephone | 937-276-9788
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Fax |
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Provider Business Mailing Address
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Address Line | 3745 ACADIA LN
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City | MASON
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State | OH
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Zip | 45036-7218
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Country | US
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Telephone | 304-521-8594
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.027241
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License Number State | OH
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