Dr. Nathaniel S. Liu, DDS a Professional Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

99424 Issued in CA

Legal business name

DR. NATHANIEL S. LIU, DDS A PROFESSIONAL CORPORATION

Practice address

28350 Via Santa Rosa
Temecula, CA 92590-5335

Phone

(619) 259-4001

Fax

(619) 393-0413

NPI assigned

Jun 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nathaniel S Liu, DDSNPI 1609930007

Title

Dentist Owner

Phone

(619) 259-4001

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Dr Nathaniel S Liu DDS a Professional Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Nathaniel S. Liu, D.D.S., a Professional Corporation

  • Dentist
  • Temecula, CA
  • NPI 1730343252
  NPD tax ID
• Tooth Fairy Dental Group

  • Dentist
  • Temecula, CA
  • NPI 1962658690
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nathaniel S Liu, DDS

  • Dentist
  • Temecula, CA
  • NPI 1609930007
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013113067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28350 VIA SANTA ROSA",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905335",
            "telephone_number": "619-259-4001",
            "fax_number": "619-393-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28350 VIA SANTA ROSA",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905335",
            "telephone_number": "619-259-4001",
            "fax_number": "619-393-0413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 Tierra Del Rey",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919107865",
            "country_code": "US",
            "telephone_number": "619-482-1210",
            "fax_number": "619-477-7775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. NATHANIEL S. LIU, DDS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "619-259-4001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "99424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "G9818801",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9242601",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "924775",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr. Javier Rios, a Medical Corporation (Temecula Clinica Medica Familiar)
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• Dr. Nathaniel S. Liu, D.D.S., a Professional Corporation
• Douglas A Drake, PA
• Enriqueta Drake
• Melinda Geremillo Drake, LISW-CP AND AP, LCSW
• Sandra Drake, LMFT
• Shyla D Drake

• Pediatric Dentistry in Temecula, CA
• Providers in Temecula, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.