Provider Demographics
NPI:1407041304
Name:XUSHENG MU, D.D.S., INC.
Entity Type:Organization
Organization Name:XUSHENG MU, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:XUSHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:MU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-270-4588
Mailing Address - Street 1:4716 CLAIREMONT MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-2006
Mailing Address - Country:US
Mailing Address - Phone:858-270-4588
Mailing Address - Fax:858-272-8030
Practice Address - Street 1:4716 CLAIREMONT MESA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-2006
Practice Address - Country:US
Practice Address - Phone:858-270-4588
Practice Address - Fax:858-272-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45930305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93064-01OtherDENTI-CAL