Individual provider Active NPI

Anna Liviz, D.D.S.

  • General Practice Dentistry
  • San Mateo, CA
National Provider Identifier
1144247107
Registry record updated Mar 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42175 Issued in CA
Practice address
324 N San Mateo Dr Ste 2
San Mateo, CA 94401-2514
Phone
(650) 343-5555
Fax
(650) 343-2225
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2009

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 42175 CA Primary

Addresses

Primary practice location

324 N San Mateo Dr Ste 2
San Mateo, CA 94401-2514

Mailing address

1161 Blythe St
Foster City, CA 94404-3645
Phone (650) 574-3366

Other identifiers 1

IdentifierTypeStateIssuer
B42175-01MedicaidCA

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

LicenseStateTypeSpecialty
42175CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235865600000",
    "number": "1144247107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 BLYTHE ST",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944043645",
            "telephone_number": "650-574-3366",
            "fax_number": "650-343-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 N SAN MATEO DR STE 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012514",
            "telephone_number": "650-343-5555",
            "fax_number": "650-343-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVIZ",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2009-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B42175-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2009; 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.