Provider Demographics
NPI:1649429044
Name:LI, HONG (DDS, MSC PHD)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DDS, MSC PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 NE CAMPUS WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5611
Mailing Address - Country:US
Mailing Address - Phone:503-952-2164
Mailing Address - Fax:503-526-4418
Practice Address - Street 1:11011 MERIDIAN AVE N
Practice Address - Street 2:STE. 104
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8967
Practice Address - Country:US
Practice Address - Phone:206-365-0378
Practice Address - Fax:206-365-0398
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00085111223E0200X
WADE000085111223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics