Provider Demographics
NPI:1124297973
Name:MENG SYN DDS
Entity type:Organization
Organization Name:MENG SYN DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MENG
Authorized Official - Middle Name:K
Authorized Official - Last Name:SYN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-224-0404
Mailing Address - Street 1:841 BLOSSOM HILL RD STE 213
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2704
Mailing Address - Country:US
Mailing Address - Phone:408-224-0404
Mailing Address - Fax:408-224-0447
Practice Address - Street 1:841 BLOSSOM HILL RD STE 213
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-2704
Practice Address - Country:US
Practice Address - Phone:408-224-0404
Practice Address - Fax:408-224-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32185122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty