Provider Demographics
NPI:1881374213
Name:HSIEH, JOCELYN
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:HSIEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3561 W CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90303-1223
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3561 W CENTURY BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-1223
Practice Address - Country:US
Practice Address - Phone:323-483-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2025-11-11
Deactivation Date:2024-02-26
Deactivation Code:
Reactivation Date:2025-08-19
Provider Licenses
StateLicense IDTaxonomies
CA112436122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist