Organization provider

SHELDON XIAOCHEN LU DMD INC

Periodontics General Practice Dentistry Medicare enrolled

SHELDON XIAOCHEN LU DMD INC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1417479890, based in Tustin, CA. The organization lists 2 taxonomy classifications, with Periodontics recorded as primary.

Getting there

The practice address on file is 17501 IRVINE BLVD SUITE 101, Tustin, CA 92780. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

17501 IRVINE BLVD SUITE 101, Tustin, CA 92780 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
64765 CA Periodontics primary
61156 CA General Practice Dentistry
56342 CA General Practice Dentistry

This provider holds licence 64765 issued in CA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Part B Supplier - Clinic/group Practice
PAC ID
1456619147
Enrollment ID
O20180102000894

Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Periodontics covers

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. NUCC Health Care Provider Taxonomy, code 1223P0300X
Dental Providers Dentist Periodontics

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
1223P0300X Periodontics Periodontics 64765 CA primary
1223G0001X General Practice Dentistry General Practice 61156 CA
1223G0001X General Practice Dentistry General Practice 56342 CA

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.

NPI1417479890 valid check digit
Entity typeOrganization (NPI-2)
Enumeration dateJul 7, 2017
Last updatedJul 21, 2022
StatusActive
Practice address 17501 IRVINE BLVD
SUITE 101
Tustin, CA 92780
(714) 835-4441
Fax (714) 835-0188
Mailing address 17501 IRVINE BLVD STE 101
Tustin, CA 92780
Other identifiers 528732 · Medicaid (CA)
The last update on file is Jul 21, 2022. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1417479890 passes the NPI check digit test The final digit 0 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 4 1 7 4 7 9 8 9
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 4 2 7 8 7 9 8 9

Sum = 80 · next multiple of 10 = 80 · check digit = 0 · actual last digit = 0

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1417479890?
NPI 1417479890 is the National Provider Identifier assigned to SHELDON XIAOCHEN LU DMD INC in Tustin, CA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Periodontics cover?
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
How do I contact SHELDON XIAOCHEN LU DMD INC?
The phone number on file with NPPES is (714) 835-4441, last updated Jul 21, 2022. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does SHELDON XIAOCHEN LU DMD INC accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1417479890 a valid number?
Yes. 1417479890 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.