Provider Demographics
NPI:1114423506
Name:SIU, ALLAN EDWIN CHUN-LUNG (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:EDWIN CHUN-LUNG
Last Name:SIU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 BIRD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1271
Mailing Address - Country:US
Mailing Address - Phone:216-856-8907
Mailing Address - Fax:
Practice Address - Street 1:1730 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-7531
Practice Address - Country:US
Practice Address - Phone:716-831-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0605121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice