Provider Demographics
NPI:1902099823
Name:EDWIN HSIUNG DDS PA
Entity Type:Organization
Organization Name:EDWIN HSIUNG DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-962-2731
Mailing Address - Street 1:12603 HENDERSON ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-6549
Mailing Address - Country:US
Mailing Address - Phone:813-962-2731
Mailing Address - Fax:813-961-4399
Practice Address - Street 1:12603 HENDERSON ROAD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-6549
Practice Address - Country:US
Practice Address - Phone:813-962-2731
Practice Address - Fax:813-961-4399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDWIN HSIUNG DDS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9374122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty