Provider Demographics
NPI:1114606324
Name:XU, ZIXIANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZIXIANG
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 GOLD ST APT 315
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1644
Mailing Address - Country:US
Mailing Address - Phone:646-427-0180
Mailing Address - Fax:
Practice Address - Street 1:680 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4705
Practice Address - Country:US
Practice Address - Phone:203-380-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT138231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics