Provider Demographics
NPI:1235811266
Name:HSIEH, ERIC (DMD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HSIEH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 S POWER RD STE 112
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3736
Mailing Address - Country:US
Mailing Address - Phone:480-764-4448
Mailing Address - Fax:
Practice Address - Street 1:1545 S POWER RD STE 112
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3736
Practice Address - Country:US
Practice Address - Phone:480-764-4448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0119201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice