Provider Demographics
NPI:1033221320
Name:NIU, DON TC (DDS)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:TC
Last Name:NIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18 ENDEAVOR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3164
Mailing Address - Country:US
Mailing Address - Phone:949-551-8877
Mailing Address - Fax:949-551-9633
Practice Address - Street 1:18 ENDEAVOR
Practice Address - Street 2:SUITE 308
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3164
Practice Address - Country:US
Practice Address - Phone:949-551-8877
Practice Address - Fax:949-551-9633
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA287751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice