Individual provider Active NPI

Stanley Yung-Chuan Liu, M.D., D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fort Lauderdale, FL
National Provider Identifier
1053601401
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
ME166358 Issued in FL
Practice address
3300 S. University Drive
Nsu Florida, Dept. of Oral & Maxillofacial Surgery
Fort Lauderdale, FL 33328-2004
Phone
(954) 262-7332
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X A122495 CA
Otolaryngology Physician 207Y00000X A122495 CA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X ME166358 FL Primary

Addresses

Primary practice location

3300 S. University Drive
Nsu Florida, Dept. of Oral & Maxillofacial Surgery
Fort Lauderdale, FL 33328-2004

Mailing address

3300 S. University Drive
Ofc 7388 (Oral & Maxillofacial Surgery)
Fort Lauderdale, FL 33328-2004
Phone (954) 262-7332

Other names 1

  • Yung-Chuan Liu Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705000337 FL Practitioner - Otolaryngology 7113158346 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME166358FLMDOral & Maxillofacial Surgery (D.M.D.)
A122495CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Current Accepting new patients
Nova Southeastern University, Inc CurrentSince Jun 20, 2024 Accepting new patients
Nova Southeastern University Inc. CurrentSince Jun 20, 2024 Accepting new patients
Nova Southeastern University, Inc PastSince Jun 2, 2024 Accepting new patients

Locations

3200 S University Dr
#L
Davie, FL 33328

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

1625 SE 3rd Ave
Ste 802
Ft Lauderdale, FL 33316
Phone (954) 262-7500

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1053601401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S. UNIVERSITY DRIVE",
            "address_2": "OFC 7388 (ORAL & MAXILLOFACIAL SURGERY)",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282004",
            "telephone_number": "954-262-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S. UNIVERSITY DRIVE",
            "address_2": "NSU FLORIDA, DEPT. OF ORAL & MAXILLOFACIAL SURGERY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282004",
            "telephone_number": "954-262-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "STANLEY YUNG-CHUAN",
        "name_prefix": "Dr.",
        "credential": "M.D., D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "A122495",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A122495",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "ME166358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YUNG-CHUAN",
            "last_name": "LIU",
            "credential": "M.D., D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.