PARK XIONG NPI 1477145449

NPI Information

  • NPI: 1477145449
  • Provider Name: PARK XIONG
  • Classification: Dental Therapist - 125J00000X
  • Entity Type: Individual
  • Address: 636 BROADWAY ST NE
    MINNEAPOLIS, MN
    ZIP 55413
  • Phone: (612) 746-1530

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NPI Details

Park Xiong is a dental therapist in Minneapolis, MN. The provider is a Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. Park Xiong NPI is 1477145449. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

636 BROADWAY ST NE
MINNEAPOLIS, MN
ZIP 55413-164
Phone: (612) 746-1530

The enumeration date for this NPI number is 2/10/2021 and was last updated on 2/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1125J00000XDental TherapistDT135MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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