Provider Demographics
NPI:1528427853
Name:ONG, SIOE HWA (DDS)
Entity type:Individual
Prefix:
First Name:SIOE
Middle Name:HWA
Last Name:ONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17906 S PIONEER BLVD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701
Mailing Address - Country:US
Mailing Address - Phone:562-860-9612
Mailing Address - Fax:562-860-5343
Practice Address - Street 1:17906 S.PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-4417
Practice Address - Country:US
Practice Address - Phone:562-860-9612
Practice Address - Fax:562-860-5343
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-15
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22436122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist