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General NPI Number Information
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NPI Number | 1396286167
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Entity Type | Individual
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Provider Name | MENG-JU DU
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Gender | Male
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1150 W MAIN ST
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City | RIPON
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State | CA
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Zip | 95366-3005
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Country | US
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Telephone | 209-599-4239
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Fax | 209-599-7899
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Provider Business Mailing Address
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Address Line | UCLA SCHOOL OF DENTISTRY 10833 LE CONTE AVE. BOX 951668
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City | LOS ANGELES
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State | CA
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Zip | 90095-1668
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Country | US
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Telephone | 310-825-8031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 104908
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License Number State | CA
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