Provider Demographics
NPI:1598800948
Name:SIOE HWA ONG DDS INC
Entity Type:Organization
Organization Name:SIOE HWA ONG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAMLET
Authorized Official - Middle Name:H
Authorized Official - Last Name:ONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-860-9612
Mailing Address - Street 1:17906 S PIONEER BLVD STE #100
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701
Mailing Address - Country:US
Mailing Address - Phone:562-860-9612
Mailing Address - Fax:562-860-5343
Practice Address - Street 1:17906 S PIONEER BLVD STE #100
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701
Practice Address - Country:US
Practice Address - Phone:562-860-9612
Practice Address - Fax:562-860-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty