Provider Demographics
NPI:1114348612
Name:XIA LLC
Entity Type:Organization
Organization Name:XIA LLC
Other - Org Name:ENDODONTIC ASSOCIATES OF EUGENE-SPRINGFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:XIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-342-5578
Mailing Address - Street 1:92865 SADDLEVIEW DR
Mailing Address - Street 2:P.O.BOX 1122
Mailing Address - City:MARCOLA
Mailing Address - State:OR
Mailing Address - Zip Code:97454-9103
Mailing Address - Country:US
Mailing Address - Phone:541-514-8785
Mailing Address - Fax:
Practice Address - Street 1:85 CENTENNIAL LOOP
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7907
Practice Address - Country:US
Practice Address - Phone:541-342-5578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD81001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty