Individual provider Active NPI

Diane Liang, D.D.S.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1073980090
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
65019 Issued in CA
Practice address
242 La Pala Dr
San Jose, CA 95127-2103
Phone
(408) 729-9700
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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 65019 CA Primary

Addresses

Primary practice location

242 La Pala Dr
San Jose, CA 95127-2103

Mailing address

1252 S Blaney Ave
San Jose, CA 95129-3706

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
I20240214000720 CA Order and Referring Only - DentistPractitioner - Dentist 3678917028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65019CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Community Health Past Accepting new patients
San Jose Foothill Family Community Clinic, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1073980090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 S BLANEY AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 LA PALA DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951272103",
            "telephone_number": "408-729-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIANG",
        "first_name": "DIANE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "65019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.