Individual provider Active NPI

Allan Edwin Chun-Lung Siu, DMD

  • General Practice Dentistry
  • Tonawanda, NY
National Provider Identifier
1114423506
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060512 Issued in NY
Practice address
1730 Niagara Falls Blvd
Tonawanda, NY 14150-7531
Phone
(716) 831-2277
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060512 NY Primary

Addresses

Primary practice location

1730 Niagara Falls Blvd
Tonawanda, NY 14150-7531

Mailing address

603 Bird Ave Apt 1
Buffalo, NY 14222-1271
Phone (216) 856-8907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
060512NYMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1114423506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BIRD AVE APT 1",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221271",
            "telephone_number": "216-856-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 NIAGARA FALLS BLVD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141507531",
            "telephone_number": "716-831-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIU",
        "first_name": "ALLAN",
        "middle_name": "EDWIN CHUN-LUNG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.