Provider Demographics
NPI:1053536136
Name:HAN, XIAO (DMD)
Entity type:Individual
Prefix:MISS
First Name:XIAO
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ELDRED ST
Mailing Address - Street 2:L
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-1420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 MANSFIELD AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1333
Practice Address - Country:US
Practice Address - Phone:508-285-4440
Practice Address - Fax:508-285-4484
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20958122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist