Provider Demographics
NPI:1487852794
Name:DO, HIEU VAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HIEU
Middle Name:VAN
Last Name:DO
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 1:4106 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-3503
Mailing Address - Country:US
Mailing Address - Phone:562-421-0981
Mailing Address - Fax:
Practice Address - Street 1:9222 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2140
Practice Address - Country:US
Practice Address - Phone:562-272-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-08
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice