Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Park Xiong

Individual provider Dental Therapist · NPI 1477145449

Park Xiong is a Dental Therapist in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2021.

Licensed in
MN
In the registry since
2021

Practice location Address checks out

636 Broadway St NE
Minneapolis, MN 55413-2164
Phone: (612) 746-1530
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Therapist (primary) Taxonomy 125J00000X · Licence DT135 (MN)

Record details

NPI number1477145449
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 10, 2021
Last updated in NPPESFebruary 10, 2021
Certification dateFebruary 10, 2021
Mailing address2590 49th St E, Inver Grove Heights, MN 55076-1158

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