Provider Demographics
NPI:1154590180
Name:HE, HONG (DDS)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:
Last Name:HE
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 1:20200 LUCILLE AVE APT 60
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2064
Mailing Address - Country:US
Mailing Address - Phone:408-368-6808
Mailing Address - Fax:408-446-1835
Practice Address - Street 1:19705 STEVENS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2405
Practice Address - Country:US
Practice Address - Phone:408-368-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice