Provider Demographics
NPI:1437314523
Name:XA, HAI (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAI
Middle Name:
Last Name:XA
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 1:893 S. RAINBOW BLVD.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145
Mailing Address - Country:US
Mailing Address - Phone:702-456-0034
Mailing Address - Fax:702-856-0035
Practice Address - Street 1:893 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-6238
Practice Address - Country:US
Practice Address - Phone:702-456-0034
Practice Address - Fax:702-856-0035
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV37801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice