Provider Demographics
NPI:1497863260
Name:LIU, IPING (DDS)
Entity Type:Individual
Prefix:DR
First Name:IPING
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1600 W REDONDO BEACH BLVD
Mailing Address - Street 2:STE 203
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3226
Mailing Address - Country:US
Mailing Address - Phone:562-864-1011
Mailing Address - Fax:310-808-0198
Practice Address - Street 1:1600 W REDONDO BEACH BLVD
Practice Address - Street 2:STE 203
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3226
Practice Address - Country:US
Practice Address - Phone:562-864-1011
Practice Address - Fax:310-808-0198
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice