Healthcare Provider Details

I. General information

NPI: 1548834781
Provider Name (Legal Business Name): HENRY HSU D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 LONG BEACH BLVD
LONG BEACH CA
90807-2003
US

IV. Provider business mailing address

4231 LONG BEACH BLVD
LONG BEACH CA
90807-2003
US

V. Phone/Fax

Practice location:
  • Phone: 562-912-4525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number111562
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: