Provider Demographics
NPI:1487721056
Name:SENG, JUSTIN YAN SING (DENTIST)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:YAN SING
Last Name:SENG
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4698 CONVOY
Mailing Address - Street 2:SU 203
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111
Mailing Address - Country:US
Mailing Address - Phone:858-565-2811
Mailing Address - Fax:858-565-2814
Practice Address - Street 1:4698 CONVOY
Practice Address - Street 2:SU 203
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111
Practice Address - Country:US
Practice Address - Phone:858-565-2811
Practice Address - Fax:858-565-2814
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice