Healthcare Provider Details

I. General information

NPI: 1639493810
Provider Name (Legal Business Name): KUEI-LING CHRISTINE HSU DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NONE NONE DDS, MS

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 07/22/2022
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W BALTIMORE ST
BALTIMORE MD
21201-1510
US

IV. Provider business mailing address

650 W BALTIMORE ST ROOM 2215
BALTIMORE MD
21201-1510
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-4213
  • Fax:
Mailing address:
  • Phone: 410-706-7970
  • Fax: 410-706-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE 60329533
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberLL739
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: