Provider Demographics
NPI:1780204313
Name:SIU, MAY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAY
Middle Name:LYNN
Last Name:SIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 LEONARD ST UNIT 211
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-3459
Mailing Address - Country:US
Mailing Address - Phone:917-971-0149
Mailing Address - Fax:
Practice Address - Street 1:5 HDSN VLY PROF PLZ
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3150
Practice Address - Country:US
Practice Address - Phone:845-562-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029104001223P0221X
390200000X
NY0625701223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program