Provider Demographics
NPI:1578227955
Name:BYUN, LIU, AND PATEL A DENTAL CORPORATION
Entity Type:Organization
Organization Name:BYUN, LIU, AND PATEL A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:JETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-967-0126
Mailing Address - Street 1:12292 NANTUCKET PL
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2772
Mailing Address - Country:US
Mailing Address - Phone:562-967-0126
Mailing Address - Fax:
Practice Address - Street 1:1161 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1938
Practice Address - Country:US
Practice Address - Phone:714-999-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty