1649315094 NPI number — LING XU DDS, PHD

Table of content: LING XU DDS, PHD (NPI 1649315094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649315094 NPI number — LING XU DDS, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
XU
Provider First Name:
LING
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS, PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649315094
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
143 WESTCHESTER HALL DEPT OF GENERAL DENTISTRY
Provider Second Line Business Mailing Address:
SCHOOL OF DENTAL MEDICINE, SUNYSB
Provider Business Mailing Address City Name:
STONY BROOK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11794-8706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-632-8740
Provider Business Mailing Address Fax Number:
631-632-3001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 JONES FRANKLIN RD STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27606-4171
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-852-0403
Provider Business Practice Location Address Fax Number:
919-852-0403
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0700X , with the licence number:  046300 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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