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NPI Code Detail

MEDICARE: MOAH KONG XIONG DDS

MEDICARE:   MOAH KONG  XIONG  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
1122300000XDentist6001557-15WI

General Provider Information

NPI Number : 1780421842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOAH KONG XIONG DDS
Provider Business Mailing Address
First Line : 726 MOORLAND RD
Second Line :
City : MADISON
State : WI
Zip : 53713-2157
Country : US
Telephone Number : 715-297-6506
Fax Number :
Provider Business Practice Location Address
First Line : 140 N CITY STATION DR
Second Line :
City : SUN PRAIRIE
State : WI
Zip : 53590-4642
Country : US
Telephone Number : 608-837-9800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2024
Last Update Date : 07/15/2024

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Directions to “ MOAH KONG XIONG DDS” Practice Location

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