Provider Demographics
NPI:1891847570
Name:HAO, WEIXIONG STEPHEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:WEIXIONG
Middle Name:STEPHEN
Last Name:HAO
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 1:2045 SUSSEX BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3214
Mailing Address - Country:US
Mailing Address - Phone:610-457-1240
Mailing Address - Fax:
Practice Address - Street 1:6 GARRETT RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2303
Practice Address - Country:US
Practice Address - Phone:610-352-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036164L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice