Provider Demographics
NPI:1982885729
Name:STEVEN K. LIU, DDS, INC.
Entity Type:Organization
Organization Name:STEVEN K. LIU, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-622-1343
Mailing Address - Street 1:455 N. MEDNIK AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1324
Mailing Address - Country:US
Mailing Address - Phone:323-267-1343
Mailing Address - Fax:323-267-1950
Practice Address - Street 1:455 N. MEDNIK AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1324
Practice Address - Country:US
Practice Address - Phone:323-267-1343
Practice Address - Fax:323-267-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA30614Medicaid
CAD30614-01OtherMEDI-CAL