Provider Demographics
NPI:1659186625
Name:XIU, JINGMIN
Entity type:Individual
Prefix:
First Name:JINGMIN
Middle Name:
Last Name:XIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13740 KENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-4008
Mailing Address - Country:US
Mailing Address - Phone:626-321-9219
Mailing Address - Fax:
Practice Address - Street 1:767 N HILL ST STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2365
Practice Address - Country:US
Practice Address - Phone:213-808-1792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist