Provider Demographics
NPI:1689227837
Name:LIAN, YUXIANG (DDS)
Entity Type:Individual
Prefix:
First Name:YUXIANG
Middle Name:
Last Name:LIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7140 112TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4623
Mailing Address - Country:US
Mailing Address - Phone:443-739-8568
Mailing Address - Fax:
Practice Address - Street 1:272 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-1848
Practice Address - Country:US
Practice Address - Phone:860-296-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist