Provider Demographics
NPI:1982942892
Name:SIU, LAWRENCE HSUNG-YI ((DENTIST) DDSPC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:HSUNG-YI
Last Name:SIU
Suffix:
Gender:M
Credentials:(DENTIST) DDSPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 CARROLL AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912
Mailing Address - Country:US
Mailing Address - Phone:301-270-0066
Mailing Address - Fax:301-270-5229
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912
Practice Address - Country:US
Practice Address - Phone:301-270-0066
Practice Address - Fax:301-270-5229
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD84491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice