Individual provider Active NPI

James Liu, D.D.S.

  • Dentist
  • Lynnwood, WA
National Provider Identifier
1235308032
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010177 Issued in WA
Practice address
1233 164TH St SW Ste H
Lynnwood, WA 98087-8193
Phone
(425) 787-2402
NPI assigned
Feb 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00010177 WA Primary

Addresses

Primary practice location

1233 164TH St SW Ste H
Lynnwood, WA 98087-8193

Mailing address

1233 164TH St SW Ste H
Lynnwood, WA 98087-8193
Phone (425) 787-2402

Other practice location 1

17265 SE Wax Rd Ste 101
Covington, WA 98042-9102
Phone (253) 639-6868

Other practice location 2

15446 Bel Red Rd Ste 400
Redmond, WA 98052-5505
Phone (630) 728-6154

Other practice location 3

907 Frontier Cir E Ste 100
Lake Stevens, WA 98258-2423
Phone (425) 697-9219

Other practice location 4

4202 198th St SW Ste 3
Lynnwood, WA 98036-6730
Phone (425) 775-0651

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
I20150728004030 CA Order and Referring Only - DentistPractitioner - Dentist 6406160084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lynnwood Dental Excellence DDS MSD PS Inc CurrentSince Nov 26, 2020 Accepting new patients
Martha Lake Dental Center Dentist PastSince Nov 15, 2020 Accepting new patients
Nurani, Mitchell, Kim, PC Dentist Past Accepting new patients

Locations

4202 198th St SW
Ste 3
Lynnwood, WA 98036
Phone (425) 775-0651

Organizations & group practices 3

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": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1235308032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 164TH ST SW STE H",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980878193",
            "telephone_number": "425-787-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 164TH ST SW STE H",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980878193",
            "telephone_number": "425-787-2402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17265 SE Wax Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "WA",
            "postal_code": "980429102",
            "country_code": "US",
            "telephone_number": "253-639-6868",
            "fax_number": "253-639-7818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15446 Bel Red Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980525505",
            "country_code": "US",
            "telephone_number": "630-728-6154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "907 Frontier Cir E Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lake Stevens",
            "state": "WA",
            "postal_code": "982582423",
            "country_code": "US",
            "telephone_number": "425-697-9219",
            "fax_number": "425-697-9228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4202 198th St SW Ste 3",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366730",
            "country_code": "US",
            "telephone_number": "425-775-0651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-26",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.