Provider Demographics
NPI:1225280068
Name:LIANG, JENNY L (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:L
Last Name:LIANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26032 MARGUERITE PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5281
Mailing Address - Country:US
Mailing Address - Phone:949-348-0880
Mailing Address - Fax:949-348-1627
Practice Address - Street 1:26032 MARGUERITE PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-5281
Practice Address - Country:US
Practice Address - Phone:949-348-0880
Practice Address - Fax:949-348-1627
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18403122300000X
CA61285122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA61285OtherDENTAL LICENSE
CAFL3200158OtherDEA