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
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 9212 | NC | N |   | Dental Providers | Dentist | General Practice | 1223G0001X | 5844C1 | AL | Y |   | Dental Providers | Dentist | General Practice |
No ID Information.