Healthcare Provider Details

I. General information

NPI: 1134052111
Provider Name (Legal Business Name): NINA REBECCA HSU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32280 FIVE MILE RD
LIVONIA MI
48154-6112
US

IV. Provider business mailing address

32280 FIVE MILE RD
LIVONIA MI
48154-6112
US

V. Phone/Fax

Practice location:
  • Phone: 734-230-2783
  • Fax:
Mailing address:
  • Phone: 734-230-2783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901603048
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: