Provider Demographics
NPI:1699660753
Name:FU, HSIANG (DMD)
Entity type:Individual
Prefix:
First Name:HSIANG
Middle Name:
Last Name:FU
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 1:3502 ORQUIDEA LN
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92823-6372
Mailing Address - Country:US
Mailing Address - Phone:626-383-5630
Mailing Address - Fax:
Practice Address - Street 1:2071 RANCHO VALLEY DR STE 140
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-7105
Practice Address - Country:US
Practice Address - Phone:909-374-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1116451223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice