Provider Demographics
NPI:1548234214
Name:I-HSIN, LIU (DMD)
Entity Type:Individual
Prefix:
First Name:LIU
Middle Name:
Last Name:I-HSIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1614
Mailing Address - Country:US
Mailing Address - Phone:201-796-2729
Mailing Address - Fax:201-796-2729
Practice Address - Street 1:1 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1614
Practice Address - Country:US
Practice Address - Phone:201-796-2729
Practice Address - Fax:201-796-2729
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ136221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice