Active NPI
Tong Liu, D.M.D.
- Pediatric Dentistry
- Fort Myers, FL
National Provider Identifier
1043665227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN23996
- Practice address
- 8016 Summerlin Lakes Dr
Fort Myers, FL 33907 - Phone
- (239) 482-2722
- NPI assigned
- Apr 26, 2016
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D010515 | AZ | |
| Pediatric Dentistry | 1223P0221X | 35803 | TX | |
| Pediatric Dentistry | 1223P0221X | DN23996 | FL | Primary |
Addresses
Primary practice location
8016 Summerlin Lakes Dr
Fort Myers, FL 33907
Mailing address
3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3504
Other practice location 1
3000 Arlington Ave # MS 1050
Graduate Medical Education
Toledo, OH 43614-2595
Phone (419) 383-3504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160819002051 | OH | Order and Referring Only - Dentist | 1557656295 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D010515 | AZ | MD | Pediatric Dentist |
| DN23996 | FL | MD | Pediatric Dentist |
| 35803 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1043665227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 ARLINGTON AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436142595",
"telephone_number": "419-383-3504",
"fax_number": "419-383-2969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8016 SUMMERLIN LAKES DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33907",
"telephone_number": "239-482-2722"
}
],
"practiceLocations": [
{
"address_1": "3000 Arlington Ave # MS 1050",
"address_2": "Graduate Medical Education",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436142595",
"country_code": "US",
"telephone_number": "419-383-3504",
"fax_number": "419-383-6127",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIU",
"first_name": "TONG",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-26",
"last_updated": "2022-07-21",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AZ",
"license": "D010515",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "35803",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN23996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.