Provider Demographics
NPI:1548783087
Name:ZENG, SIDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIDA
Middle Name:
Last Name:ZENG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6824 TERRA RYE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2757
Mailing Address - Country:US
Mailing Address - Phone:210-504-5995
Mailing Address - Fax:
Practice Address - Street 1:8210 FLOYD CURL DRIVE
Practice Address - Street 2:GPG 8
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-450-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33252122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist