Provider Demographics
NPI:1083382766
Name:XU, ZHEWU (DMD)
Entity Type:Individual
Prefix:
First Name:ZHEWU
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2593 BROOKLINE CIR NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3691
Mailing Address - Country:US
Mailing Address - Phone:404-775-3180
Mailing Address - Fax:
Practice Address - Street 1:3435 LENOX RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1308
Practice Address - Country:US
Practice Address - Phone:678-248-6268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1222761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice