Basic Information
Provider Information
NPI: 1316232838
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHANG
FirstName: XUEMING
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ZHANG
OtherFirstName: ERIC
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: DMD
OtherLastNameType: 5
Mailing Information
Address1: 5186 LAKE CREST CIR
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352265027
CountryCode: US
TelephoneNumber: 2052223382
FaxNumber:  
Practice Location
Address1: 111 B Y WILLIAMS SR DR
Address2:  
City: MIDFIELD
State: AL
PostalCode: 352282218
CountryCode: US
TelephoneNumber: 2059233172
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/13/2011
LastUpdateDate: 11/05/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X9212NCN Dental ProvidersDentistGeneral Practice
1223G0001X5844C1ALY Dental ProvidersDentistGeneral Practice

No ID Information.


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