Provider Demographics
NPI:1851439871
Name:HAO, AMY C (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:C
Last Name:HAO
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 1:1201 UNIVERSITY AVE
Mailing Address - Street 2:#211
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-4511
Mailing Address - Country:US
Mailing Address - Phone:951-786-9141
Mailing Address - Fax:951-788-9420
Practice Address - Street 1:1201 UNIVERSITY AVE
Practice Address - Street 2:#211
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-4511
Practice Address - Country:US
Practice Address - Phone:951-786-9141
Practice Address - Fax:951-788-9420
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA394121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice