Provider Demographics
NPI:1083831812
Name:HSU, YIN (DMD, MPH)
Entity Type:Individual
Prefix:
First Name:YIN
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128A TREMONT ST
Mailing Address - Street 2:FL2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-4716
Mailing Address - Country:US
Mailing Address - Phone:617-423-0505
Mailing Address - Fax:617-423-4259
Practice Address - Street 1:128A TREMONT ST
Practice Address - Street 2:FL2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4716
Practice Address - Country:US
Practice Address - Phone:617-423-0505
Practice Address - Fax:617-423-4259
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA182151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice