Healthcare Provider Details

I. General information

NPI: 1568148013
Provider Name (Legal Business Name): CHUYEN HSU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 CENTRAL ST
STOUGHTON MA
02072-4407
US

IV. Provider business mailing address

601 ALBANY ST UNIT 208
BOSTON MA
02118-2790
US

V. Phone/Fax

Practice location:
  • Phone: 781-514-5465
  • Fax:
Mailing address:
  • Phone: 617-671-9607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1860005
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1860005
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: