Provider Demographics
NPI:1346805603
Name:SHIH-YEN PAUL HSIAO, DDS, MPH, JD, INC.
Entity Type:Organization
Organization Name:SHIH-YEN PAUL HSIAO, DDS, MPH, JD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SHIH-YEN PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPH, JD
Authorized Official - Phone:909-991-8808
Mailing Address - Street 1:5678 N PALM AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1850
Mailing Address - Country:US
Mailing Address - Phone:559-225-1400
Mailing Address - Fax:
Practice Address - Street 1:5678 N PALM AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1850
Practice Address - Country:US
Practice Address - Phone:559-225-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1Medicaid