Provider Demographics
NPI:1013438134
Name:LI, XIANG (DDS)
Entity Type:Individual
Prefix:
First Name:XIANG
Middle Name:
Last Name:LI
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 1:13105 40TH RD APT 10S
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5192
Mailing Address - Country:US
Mailing Address - Phone:224-944-6759
Mailing Address - Fax:
Practice Address - Street 1:13105 40TH RD APT 10S
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5192
Practice Address - Country:US
Practice Address - Phone:224-944-6759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program