Provider Demographics
NPI:1144477910
Name:LU, MEI (DDS, MS, PHD)
Entity type:Individual
Prefix:DR
First Name:MEI
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 BARTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4229
Mailing Address - Country:US
Mailing Address - Phone:909-792-1093
Mailing Address - Fax:909-793-4531
Practice Address - Street 1:1690 BARTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4229
Practice Address - Country:US
Practice Address - Phone:909-792-1093
Practice Address - Fax:909-793-4531
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA575031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA57503OtherSTATE LICENSE