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PARK XIONG
NPI 1477145449
Dental Therapist in Minneapolis, MN

Active since February 10, 2021
636 BROADWAY ST NE, MINNEAPOLIS, MN 55413(612) 746-1530 Get Directions Write a Review

NPPES record last updated: February 10, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Park Xiong NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARK XIONG (NPI 1477145449) is an individual dental therapist in Minneapolis, Minnesota, licensed in Minnesota (DT135) and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1477145449
Entity TypeIndividualMale
Primary Taxonomy125J00000X
Provider Legal NamePARK XIONG
Location Address636 BROADWAY ST NEMinneapolis, MN 55413-2164
Mailing Address2590 49th St EInver Grove Heights, MN 55076-1158
Phone(612) 746-1530
Sole ProprietorNo
Enumeration DateFebruary 10, 2021
NPPES CertifiedFebruary 10, 2021
✔ NPI 1477145449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDental TherapistDental Providers
Taxonomy Code125J00000X
License✔ Licensed in MN · DT135
Definition
A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations.
636 BROADWAY ST NE, Minneapolis, MN 55413
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. HEATHER GLOCKLE R.D.H.
Dental Hygienist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530
SONDRA NICKOLSON R.D.H., M.E.D.
Dental Hygienist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530
NICOLE MATHEW DT
Dental Therapist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530
MRS. TERESA BUSHNELL
Dental Therapist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530
TRINA COURTRIGHT D.T.
Dental Therapist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530
BECKY LOMMEN
Dental Hygienist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530
JODI BECKER
Dental Therapist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530
MELISSA JO CASPER
Dental Hygienist
636 BROADWAY ST NE
MINNEAPOLIS, MN 55413
Hennepin County (612) 746-1530

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Park Xiong's NPI number?

The NPI number for Park Xiong is 1477145449. It was assigned to this individual provider in the NPPES registry on February 10, 2021.

Where is Park Xiong located?

Park Xiong practices at 636 Broadway St NE, Minneapolis, MN 55413. The listed phone number is (612) 746-1530.

What is Park Xiong's specialty?

The primary specialty registered for this NPI is Dental Therapist with taxonomy code 125J00000X.

When was this NPI record last updated?

The NPPES record for Park Xiong was last updated on February 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.