NPIMap

Organization Active NPI

Peixin Liu DDS

  • General Practice Dentistry
  • Blaine, MN
National Provider Identifier
1093842841
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12319MN Issued in MN
Legal business name
PEIXIN LIU DDS
Practice address
2407 109TH Avenue
Suite 240
Blaine, MN 55449
Phone
(763) 783-8200
Fax
(763) 783-7197
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sheri L Murray, RDA
Title
Office Manager
Phone
(763) 786-3800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D11232MN MN
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D12319MN MN Primary

Addresses

Primary practice location

2407 109TH Avenue
Suite 240
Blaine, MN 55449

Mailing address

2407 109TH Avenue
Suite 240
Blaine, MN 55449
Phone (763) 783-8200

Other identifiers 4

IdentifierTypeStateIssuer
1972584068OtherNPI
D11232OtherMNLICENSE
D12319OtherMNLICENSE
1760540942OtherNPI

Other names 1

  • Family Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Dental Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093842841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 109TH AVENUE",
            "address_2": "SUITE 240",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "763-783-8200",
            "fax_number": "763-783-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 109TH AVENUE",
            "address_2": "SUITE 240",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "763-783-8200",
            "fax_number": "763-783-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEIXIN LIU DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "763-786-3800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11232MN",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12319MN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972584068",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D11232",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D12319",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760540942",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.