MEDICARE: JOYCE YUESHUO XU MD, DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	111473	GA

General Provider Information

NPI Number	:	1285297143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE YUESHUO XU MD, DMD

Provider Business Mailing Address
First Line	:	1365 CLIFTON RD NE STE 2300
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-5279
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE STE 2300
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-5279
Fax Number	:	404-778-5879

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2019
Last Update Date	:	06/25/2026

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