Provider Demographics
NPI:1871070177
Name:SETO, HIDEKI
Entity type:Individual
Prefix:DR
First Name:HIDEKI
Middle Name:
Last Name:SETO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42816 LONGWORTH TER
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-6673
Mailing Address - Country:US
Mailing Address - Phone:646-339-3111
Mailing Address - Fax:
Practice Address - Street 1:8551 RIXLEW LN STE 130
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-4277
Practice Address - Country:US
Practice Address - Phone:703-677-8013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401416090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist