Provider Demographics
NPI:1366755001
Name:HWANG, ALEXIS LAU (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:LAU
Last Name:HWANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1625 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-4201
Mailing Address - Country:US
Mailing Address - Phone:323-268-8391
Mailing Address - Fax:
Practice Address - Street 1:1625 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4201
Practice Address - Country:US
Practice Address - Phone:323-268-8391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028261122300000X
CA60726122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist