Provider Demographics
NPI:1184709735
Name:HSIEH, TSUNG-JU (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:TSUNG-JU
Middle Name:
Last Name:HSIEH
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:HSIEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MSD
Mailing Address - Street 1:51701 COLUMBIA RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-4408
Mailing Address - Country:US
Mailing Address - Phone:503-987-1378
Mailing Address - Fax:503-467-5592
Practice Address - Street 1:51701 COLUMBIA RIVER HWY
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-4408
Practice Address - Country:US
Practice Address - Phone:503-987-1378
Practice Address - Fax:503-467-5592
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8383122300000X, 1223X0400X
ORD87641223P0300X
WADE00010163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics