Provider Demographics
NPI:1629400510
Name:LIU, QIONG ZHOU (DDS)
Entity Type:Individual
Prefix:
First Name:QIONG
Middle Name:ZHOU
Last Name:LIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5500 NW EXPRESSWAY
Mailing Address - Street 2:STE B
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3225 TEAKWOOD LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3721
Practice Address - Country:US
Practice Address - Phone:405-844-8887
Practice Address - Fax:405-844-9625
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist