Provider Demographics
NPI:1780893321
Name:HSIEH, SUSAN (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:HSIEH
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6378 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3036
Mailing Address - Country:US
Mailing Address - Phone:925-551-8765
Mailing Address - Fax:
Practice Address - Street 1:6378 CLARK AVE
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3036
Practice Address - Country:US
Practice Address - Phone:925-551-8765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics