Provider Demographics
NPI:1538275623
Name:WEI, XIN (DDS)
Entity type:Individual
Prefix:DR
First Name:XIN
Middle Name:
Last Name:WEI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 ABBOTTS BRIDGE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2141
Mailing Address - Country:US
Mailing Address - Phone:770-814-2212
Mailing Address - Fax:888-909-5893
Practice Address - Street 1:4317 ABBOTTS BRIDGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-2141
Practice Address - Country:US
Practice Address - Phone:770-814-2212
Practice Address - Fax:888-909-5893
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0128041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA915406162AMedicaid
GA915406162DMedicaid