Provider Demographics
NPI:1568550952
Name:AU, PHILIP WING-SHUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:WING-SHUN
Last Name:AU
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 1:75 N SANTA ANITA AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006
Mailing Address - Country:US
Mailing Address - Phone:626-446-2879
Mailing Address - Fax:
Practice Address - Street 1:75 N SANTA ANITA AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006
Practice Address - Country:US
Practice Address - Phone:626-446-2879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice