Healthcare Provider Details

I. General information

NPI: 1326902289
Provider Name (Legal Business Name): DR. FU DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 N MOUNTAIN AVE STE 123
ONTARIO CA
91762-1132
US

IV. Provider business mailing address

3502 ORQUIDEA LN
BREA CA
92823-6372
US

V. Phone/Fax

Practice location:
  • Phone: 626-383-5630
  • Fax:
Mailing address:
  • Phone: 626-383-5630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. HSIANG YOU FU
Title or Position: PRESIDENT
Credential: DMD
Phone: 626-383-5630