Meng-Ju Du

Individual provider Active NPI General Practice Dentistry · Ripon, CA

NPI 1396286167 · NPPES record last updated Dec 12, 2024

Key facts

NPI
1396286167
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
104908 (CA)
Practice address
1150 W Main St
Ripon, CA 95366-3005
Phone
(209) 599-4239
Fax
(209) 599-7899
NPI assigned
Mar 14, 2017
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 104908 CA Yes

Addresses

Primary practice location

1150 W Main St
Ripon, CA 95366-3005

Mailing address

UCLA School of Dentistry
10833 Le Conte Ave. Box 951668
Los Angeles, CA 90095-1668
Phone (310) 825-8031

Other practice location 1

Ucla School Of Dentistry
10833 Le Conte Ave. Box 951668
Los Angeles, CA 90095-1668
Phone (310) 825-8031

Other providers in Ripon, CA

All providers in Ripon, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.