Provider Demographics
NPI:1972868263
Name:LIAO, HSIN-FONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HSIN-FONG
Middle Name:
Last Name:LIAO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:LIAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:116 SW 148TH ST
Mailing Address - Street 2:D100
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1983
Mailing Address - Country:US
Mailing Address - Phone:206-426-7999
Mailing Address - Fax:206-246-7788
Practice Address - Street 1:116 SW 148TH ST
Practice Address - Street 2:D100
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1983
Practice Address - Country:US
Practice Address - Phone:206-426-7999
Practice Address - Fax:206-246-7788
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60119341122300000X, 1223E0200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice