Provider Demographics
NPI:1770240343
Name:BING ELLIOT XIA DDS INC
Entity Type:Organization
Organization Name:BING ELLIOT XIA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BING
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:XIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-986-2626
Mailing Address - Street 1:931 SAN BRUNO AVE W RM 8
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3435
Mailing Address - Country:US
Mailing Address - Phone:415-986-2626
Mailing Address - Fax:415-986-2727
Practice Address - Street 1:931 SAN BRUNO AVE W RM 8
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3435
Practice Address - Country:US
Practice Address - Phone:415-986-2626
Practice Address - Fax:415-986-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental