Provider Demographics
NPI:1386863918
Name:HSU, G-JEN (DDS)
Entity type:Individual
Prefix:DR
First Name:G-JEN
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7226 SAN RAMON RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3242
Mailing Address - Country:US
Mailing Address - Phone:925-551-3396
Mailing Address - Fax:925-551-3786
Practice Address - Street 1:7226 SAN RAMON RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3242
Practice Address - Country:US
Practice Address - Phone:925-551-3396
Practice Address - Fax:925-551-3786
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice