Provider Demographics
NPI:1861687261
Name:HSIAO, CHINCHAI (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHINCHAI
Middle Name:
Last Name:HSIAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 TOWN CENTER DR STE 105
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1748
Mailing Address - Country:US
Mailing Address - Phone:215-750-5200
Mailing Address - Fax:
Practice Address - Street 1:850 TOWN CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1748
Practice Address - Country:US
Practice Address - Phone:215-750-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-09
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037158122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No122300000XDental ProvidersDentist