Provider Demographics
NPI:1811163850
Name:HSIEH, SAMUEL TIEN-EN (DMD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:TIEN-EN
Last Name:HSIEH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 STRATHMORE RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-1967
Mailing Address - Country:US
Mailing Address - Phone:857-472-2679
Mailing Address - Fax:
Practice Address - Street 1:133 MARKET ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-6249
Practice Address - Country:US
Practice Address - Phone:978-458-1179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice