Provider Demographics
NPI:1164556395
Name:UPDIKE, SOPHIA SY-HANN XIANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:SY-HANN XIANG
Last Name:UPDIKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:SY-HANN
Other - Last Name:XIANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:13528 CHARLWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6322
Mailing Address - Country:US
Mailing Address - Phone:310-709-2960
Mailing Address - Fax:
Practice Address - Street 1:250 E YALE LOOP STE 202
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4697
Practice Address - Country:US
Practice Address - Phone:949-870-9713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA531131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics