Provider Demographics
NPI:1033498282
Name:LIU, JEFFREY CHIA-PERNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CHIA-PERNG
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 1:3451 W CENTURY BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90303-1228
Mailing Address - Country:US
Mailing Address - Phone:310-330-9000
Mailing Address - Fax:310-300-9303
Practice Address - Street 1:3451 W CENTURY BLVD STE B1
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-1228
Practice Address - Country:US
Practice Address - Phone:310-330-9000
Practice Address - Fax:310-300-9303
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60375122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist