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General NPI Number Information
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NPI Number | 1649322546
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Entity Type | Individual
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Provider Name | JOHN HSUEH JEN LIAO LEE DDS
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1250 HANCOCK STREET SUITE 123
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City | QUINCY CENTRE
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State | MA
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Zip | 02169-4339
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Country | US
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Telephone | 617-471-8161
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Fax | 617-471-8181
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Provider Business Mailing Address
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Address Line | PO BOX 610005
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City | NEWTON HIGHLANDS
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State | MA
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Zip | 02461-0005
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Country | US
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Telephone | 617-965-5967
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Fax | 617-965-5967
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18489
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 18489
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License Number State | MA
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