Active NPI
Ben Liu, D.D.S
- Pediatric Dentistry
- Hackensack, NJ
National Provider Identifier
1104120153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22DI02463300
- Practice address
- 645 Main St
Hackensack, NJ 07601-4712 - Phone
- (201) 488-8300
- NPI assigned
- Jan 5, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 22DI02463300 | NJ | Primary |
Addresses
Primary practice location
645 Main St
Hackensack, NJ 07601-4712
Mailing address
10 Regent St
#505
Jersey City, NJ 07302-7321
Phone (919) 423-2520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02463300 | NJ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294185600000",
"number": "1104120153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 REGENT ST",
"address_2": "#505",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073027321",
"telephone_number": "919-423-2520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 MAIN ST",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076014712",
"telephone_number": "201-488-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "BEN",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-05",
"last_updated": "2011-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI02463300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.