Provider Demographics
NPI:1023772175
Name:ZHAO, XUEFENG (BDS, MSOB, PHD)
Entity type:Individual
Prefix:DR
First Name:XUEFENG
Middle Name:
Last Name:ZHAO
Suffix:
Gender:M
Credentials:BDS, MSOB, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CHESTNUT ST APT 909
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4317
Mailing Address - Country:US
Mailing Address - Phone:443-449-3718
Mailing Address - Fax:
Practice Address - Street 1:2400 CHESTNUT ST APT 909
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4317
Practice Address - Country:US
Practice Address - Phone:443-449-3718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX378171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics