Provider Demographics
NPI:1669288825
Name:LIU, CHIH YEN (DDS)
Entity type:Individual
Prefix:
First Name:CHIH YEN
Middle Name:
Last Name:LIU
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1508 MORNING STAR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6551
Mailing Address - Country:US
Mailing Address - Phone:512-734-7089
Mailing Address - Fax:
Practice Address - Street 1:607 S ORCHARD ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4218
Practice Address - Country:US
Practice Address - Phone:512-734-7089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK79791223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics