Provider Demographics
NPI:1538260450
Name:HSU, TONY H (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:H
Last Name:HSU
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18575 GALE AVE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1340
Mailing Address - Country:US
Mailing Address - Phone:626-912-5988
Mailing Address - Fax:
Practice Address - Street 1:18575 GALE AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1340
Practice Address - Country:US
Practice Address - Phone:626-912-5988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA464801223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
141934362OtherEIN (EMPLOYER ID NUMBER)