Provider Demographics
NPI:1356587323
Name:SHUEN, SUWEN (DDS)
Entity type:Individual
Prefix:
First Name:SUWEN
Middle Name:
Last Name:SHUEN
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 1:39812 MISSION BLVD
Mailing Address - Street 2:STE. 109
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3056
Mailing Address - Country:US
Mailing Address - Phone:510-661-0788
Mailing Address - Fax:
Practice Address - Street 1:39812 MISSION BLVD
Practice Address - Street 2:STE. 109
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3056
Practice Address - Country:US
Practice Address - Phone:510-661-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA447771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice