Provider Demographics
NPI:1376338004
Name:LIUT, VITO ZHAODONG
Entity type:Individual
Prefix:
First Name:VITO
Middle Name:ZHAODONG
Last Name:LIUT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 UPPER SHEEP PASTURE RD
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1729
Mailing Address - Country:US
Mailing Address - Phone:510-866-3334
Mailing Address - Fax:
Practice Address - Street 1:79 UPPER SHEEP PASTURE RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1729
Practice Address - Country:US
Practice Address - Phone:510-866-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTNOT-YET-LICENSED122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist