Individual provider Active NPI

Ellen Jiachen Liang, DDS

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1063175230
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7568 Issued in NV
Practice address
7181 N Hualapai Way Ste 105
Las Vegas, NV 89166-1116
Phone
(702) 703-8609
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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 7568 NV Primary

Addresses

Primary practice location

7181 N Hualapai Way Ste 105
Las Vegas, NV 89166-1116

Mailing address

9950 W Tropicana Ave Apt 1052
Las Vegas, NV 89147-8543
Phone (415) 815-6218

Other practice location 1

10965 Lavender Hill Dr Ste 120
Las Vegas, NV 89135-2951
Phone (702) 983-1728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230509001369 CA Order and Referring Only - DentistPractitioner - Dentist 3173988565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1063175230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9950 W TROPICANA AVE APT 1052",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478543",
            "telephone_number": "415-815-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7181 N HUALAPAI WAY STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891661116",
            "telephone_number": "702-703-8609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10965 Lavender Hill Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891352951",
            "country_code": "US",
            "telephone_number": "702-983-1728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIANG",
        "first_name": "ELLEN",
        "middle_name": "JIACHEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.