Provider Demographics
NPI:1609088624
Name:NANCY KWON HSIEH, DDS, INC
Entity Type:Organization
Organization Name:NANCY KWON HSIEH, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:KWON
Authorized Official - Last Name:HSIEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:415-567-1532
Mailing Address - Street 1:3400 CALIFORNIA ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1863
Mailing Address - Country:US
Mailing Address - Phone:415-567-1532
Mailing Address - Fax:
Practice Address - Street 1:3400 CALIFORNIA ST
Practice Address - Street 2:SUITE 302
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1863
Practice Address - Country:US
Practice Address - Phone:415-567-1532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504011223G0001X
CA502971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty