Provider Demographics
NPI:1134307895
Name:HILO, ED
Entity Type:Individual
Prefix:DR
First Name:ED
Middle Name:
Last Name:HILO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BENTLEY CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4873
Mailing Address - Country:US
Mailing Address - Phone:847-236-0889
Mailing Address - Fax:
Practice Address - Street 1:4767 LAFAYETTE ST STE 104
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-1600
Practice Address - Country:US
Practice Address - Phone:408-727-0722
Practice Address - Fax:408-727-5774
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice