Provider Demographics
NPI:1518262849
Name:LIU, JIE (DDS, MS)
Entity Type:Individual
Prefix:
First Name:JIE
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 LOUETTA RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4405
Mailing Address - Country:US
Mailing Address - Phone:832-663-9024
Mailing Address - Fax:
Practice Address - Street 1:4000 LOUETTA RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4405
Practice Address - Country:US
Practice Address - Phone:832-663-9024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60333315122300000X
TX29126122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist