Provider Demographics
NPI:1821188699
Name:ABAYA, JUDITH LIAO (DDS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LIAO
Last Name:ABAYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 HICKEY BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2629
Mailing Address - Country:US
Mailing Address - Phone:650-757-6688
Mailing Address - Fax:650-757-6556
Practice Address - Street 1:455 HICKEY BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2629
Practice Address - Country:US
Practice Address - Phone:650-757-6688
Practice Address - Fax:650-757-6556
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA368801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice