Provider Demographics
NPI:1003806001
Name:LIU, BARRY RANDALL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:RANDALL
Last Name:LIU
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 1:914 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2308
Mailing Address - Country:US
Mailing Address - Phone:510-526-1424
Mailing Address - Fax:510-524-7608
Practice Address - Street 1:914 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2308
Practice Address - Country:US
Practice Address - Phone:510-526-1424
Practice Address - Fax:510-524-7608
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice