Provider Demographics
NPI:1417080284
Name:HSIEH, CHARLIE C (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLIE
Middle Name:C
Last Name:HSIEH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 W LA VETA
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-771-0181
Mailing Address - Fax:714-771-6448
Practice Address - Street 1:805 W LA VETA
Practice Address - Street 2:SUITE 208
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-771-0181
Practice Address - Fax:714-771-6448
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42329122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist