Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 058168 | NY |
Y | 1223P0221X | Pediatric Dentist | 101432 | CA |
NPI | 1053651778 |
---|---|
Provider Name | Dr. Susan Minh Do |
First Address | Orange, CA 92869-4382 |
Second Address | Huntington Beach, CA 92646-2552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2013 |
Last Update Date | 18/11/2021 |