Provider Demographics
NPI:1760221519
Name:HSU, TZU YI (DMD)
Entity type:Individual
Prefix:DR
First Name:TZU YI
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:CLEMENT
Other - Middle Name:
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:59 MAPLE AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1667
Mailing Address - Country:US
Mailing Address - Phone:857-316-5112
Mailing Address - Fax:
Practice Address - Street 1:650 COURT ST STE 4
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1759
Practice Address - Country:US
Practice Address - Phone:603-352-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK7933122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program