Provider Demographics
NPI:1588874564
Name:HSIAO, CHI (DMD)
Entity type:Individual
Prefix:
First Name:CHI
Middle Name:
Last Name:HSIAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 SKAGIT KY
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1031
Mailing Address - Country:US
Mailing Address - Phone:425-766-1658
Mailing Address - Fax:
Practice Address - Street 1:2623 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1309
Practice Address - Country:US
Practice Address - Phone:206-441-2774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000079391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice