Individual provider Active NPI

Diana Wen-Wei Liu, DDS

  • General Practice Dentistry
  • Centerville, MA
National Provider Identifier
1033255211
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20764 Issued in MA
Practice address
1645 Falmouth Rd Ste 4B
Centerville, MA 02632-2934
Phone
(508) 771-0605
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20764 MA Primary

Addresses

Primary practice location

1645 Falmouth Rd Ste 4B
Centerville, MA 02632-2934

Mailing address

1645 Falmouth Rd Ste 4B
Centerville, MA 02632-2934
Phone (508) 771-0605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151119000480 MA Order and Referring Only - DentistPractitioner - Dentist 5799085973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20764MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1033255211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 FALMOUTH RD STE 4B",
            "city": "CENTERVILLE",
            "state": "MA",
            "postal_code": "026322934",
            "telephone_number": "508-771-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 FALMOUTH RD STE 4B",
            "city": "CENTERVILLE",
            "state": "MA",
            "postal_code": "026322934",
            "telephone_number": "508-771-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "DIANA",
        "middle_name": "WEN-WEI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, MA

Sources for this page

Verify at the official NPI Registry.