Provider Demographics
NPI:1609216332
Name:HSIAO, ERICA (DDS)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:HSIAO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 PROFESSIONAL DR STE 115
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3778
Mailing Address - Country:US
Mailing Address - Phone:602-751-6402
Mailing Address - Fax:916-783-5614
Practice Address - Street 1:2110 PROFESSIONAL DR STE 115
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3778
Practice Address - Country:US
Practice Address - Phone:602-751-6402
Practice Address - Fax:916-783-5614
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029270122300000X
CA63898122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist