Provider Demographics
NPI:1558435685
Name:HSIA, LYNNE W (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:W
Last Name:HSIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6954
Mailing Address - Country:US
Mailing Address - Phone:707-938-7660
Mailing Address - Fax:
Practice Address - Street 1:248 PERKINS ST
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6954
Practice Address - Country:US
Practice Address - Phone:707-938-7660
Practice Address - Fax:707-721-1635
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA477301223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry