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NPI Code Detail

MEDICARE: MIKE XING DDS

MEDICARE: MIKE XING DDS
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
11223G0001XGeneral Practice Dentistry106895CA

General Provider Information

NPI Number : 1598426413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKE XING DDS
Provider Business Mailing Address
First Line : 1551 CAROLYN CT
Second Line :
City : REDLANDS
State : CA
Zip : 92374-4738
Country : US
Telephone Number : 909-747-8298
Fax Number :
Provider Business Practice Location Address
First Line : 25054 BASE LINE ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92410-4026
Country : US
Telephone Number : 909-889-9591
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2022
Last Update Date : 12/30/2022

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Directions to “ MIKE XING DDS” Practice Location

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