Healthcare Provider Details

I. General information

NPI: 1407685548
Provider Name (Legal Business Name): STEPHANIE HSU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 LARKSPUR LN
EPHRATA PA
17522-8402
US

IV. Provider business mailing address

193 LARKSPUR LN
EPHRATA PA
17522-8402
US

V. Phone/Fax

Practice location:
  • Phone: 717-219-4214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS046080
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: