Provider Demographics
NPI:1396957494
Name:DO, HIENTHU T (DDS)
Entity type:Individual
Prefix:
First Name:HIENTHU
Middle Name:T
Last Name:DO
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 1:7440 EL MORRO WAY
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-2607
Mailing Address - Country:US
Mailing Address - Phone:323-266-2120
Mailing Address - Fax:323-266-7297
Practice Address - Street 1:2319 S ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-1201
Practice Address - Country:US
Practice Address - Phone:323-266-2120
Practice Address - Fax:323-266-7297
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA439381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB43938-01OtherDENTI-CAL PROVIDER NUMBER