Healthcare Provider Details

I. General information

NPI: 1750380127
Provider Name (Legal Business Name): EUGENE SHIH-YU HSU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5611 119TH AVE SE STE 1
BELLEVUE WA
98006-3799
US

IV. Provider business mailing address

5611 119TH AVE SE STE 1
BELLEVUE WA
98006-3799
US

V. Phone/Fax

Practice location:
  • Phone: 425-746-6454
  • Fax: 425-746-6458
Mailing address:
  • Phone: 425-746-6454
  • Fax: 425-746-6458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00008733
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: