Provider Demographics
NPI:1174915664
Name:BRIEN HSU DDS INC
Entity type:Organization
Organization Name:BRIEN HSU DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-941-2811
Mailing Address - Street 1:11458 KENYON WAY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-9219
Mailing Address - Country:US
Mailing Address - Phone:909-941-2811
Mailing Address - Fax:909-941-7271
Practice Address - Street 1:11458 KENYON WAY
Practice Address - Street 2:SUITE 120
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-9219
Practice Address - Country:US
Practice Address - Phone:909-941-2811
Practice Address - Fax:909-941-7271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47485122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty