Provider Demographics
NPI:1306626544
Name:XU, NANCY XIAONAN (DDS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:XIAONAN
Last Name:XU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8103 S CONGRESS AVE UNIT 1219
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4068
Mailing Address - Country:US
Mailing Address - Phone:737-330-7316
Mailing Address - Fax:
Practice Address - Street 1:801 E WILLIAM CANNON DR STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-6671
Practice Address - Country:US
Practice Address - Phone:512-717-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40065122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist