Provider Demographics
NPI:1205837739
Name:MENG, SARA ELAINE (DDS PA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELAINE
Last Name:MENG
Suffix:
Gender:F
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4500
Mailing Address - Country:US
Mailing Address - Phone:316-943-2327
Mailing Address - Fax:316-941-4194
Practice Address - Street 1:3455 W 13TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4500
Practice Address - Country:US
Practice Address - Phone:316-943-2327
Practice Address - Fax:316-941-4194
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-08-10
Deactivation Date:2006-02-07
Deactivation Code:
Reactivation Date:2007-08-10
Provider Licenses
StateLicense IDTaxonomies
KS60254122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist