Provider Demographics
NPI:1558608851
Name:DR. I LIU DENTAL CORP
Entity Type:Organization
Organization Name:DR. I LIU DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IPING
Authorized Official - Middle Name:IRIS
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-746-2776
Mailing Address - Street 1:860 E REMINGTON DR
Mailing Address - Street 2:STE. H
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2995
Mailing Address - Country:US
Mailing Address - Phone:408-730-0888
Mailing Address - Fax:
Practice Address - Street 1:860 E REMINGTON DR
Practice Address - Street 2:STE. H
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2995
Practice Address - Country:US
Practice Address - Phone:408-730-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29231DDS261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental