Individual provider Active NPI

Lori Liu, D.M.D

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1073831988
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054953 Issued in NY
Practice address
88 Hester St
Apt 3a
New York, NY 10002-5209
Phone
(201) 294-0064
NPI assigned
May 17, 2010
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02414100 NJ
General Practice Dentistry 1223G0001X 054953 NY Primary

Addresses

Primary practice location

88 Hester St
Apt 3a
New York, NY 10002-5209

Mailing address

88 Hester St
Apt 3a
New York, NY 10002-5209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20161227000744 NJ Order and Referring Only - DentistPractitioner - Dentist 7113208554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02414100NJMDGeneral Practice Dentistry
054953NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1073831988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 HESTER ST",
            "address_2": "APT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 HESTER ST",
            "address_2": "APT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025209",
            "telephone_number": "201-294-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "LORI",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02414100",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.