Active NPI
Jiawei Liu
- Dentist
- Brea, CA
National Provider Identifier
1124717954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS111603
- Practice address
- 115 S State College Blvd Unit 362
Brea, CA 92821-1614 - Phone
- (408) 666-6276
- NPI assigned
- May 8, 2023
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DDS111603 | CA | Primary |
Addresses
Primary practice location
115 S State College Blvd Unit 362
Brea, CA 92821-1614
Mailing address
115 S State College Blvd Unit 362
Brea, CA 92821-1614
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 |
|---|---|---|---|
| DDS111603 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751414400000",
"number": "1124717954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 S STATE COLLEGE BLVD UNIT 362",
"city": "BREA",
"state": "CA",
"postal_code": "928211614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 S STATE COLLEGE BLVD UNIT 362",
"city": "BREA",
"state": "CA",
"postal_code": "928211614",
"telephone_number": "408-666-6276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "JIAWEI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-08",
"last_updated": "2025-07-02",
"certification_date": "2025-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS111603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.