Provider Demographics
NPI:1003940446
Name:SIEU, TONY (DDS)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:SIEU
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 1:22500 NE MARKETPLACE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-2033
Mailing Address - Country:US
Mailing Address - Phone:425-868-6600
Mailing Address - Fax:
Practice Address - Street 1:22500 NE MARKETPLACE DR STE 201
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-2033
Practice Address - Country:US
Practice Address - Phone:425-868-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000079361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice