Individual provider Active NPI

Rick Y Lieu, DDS

  • General Practice Dentistry
  • Puyallup, WA
National Provider Identifier
1255473989
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008859 Issued in WA
Practice address
8604 112TH St E
Puyallup, WA 98373-3857
Phone
(253) 845-0558
Fax
(253) 841-0980
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 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 DE00008859 WA Primary

Addresses

Primary practice location

8604 112TH St E
Puyallup, WA 98373-3857

Mailing address

8604 112TH St E
Puyallup, WA 98373-3857
Phone (253) 845-0558

Other identifiers 1

IdentifierTypeStateIssuer
5038427MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160127001387 WA Order and Referring Only - DentistPractitioner - Dentist 7911200803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rick Y. Lieu, D.D.S.,PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1255473989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8604 112TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733857",
            "telephone_number": "253-845-0558",
            "fax_number": "253-841-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8604 112TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733857",
            "telephone_number": "253-845-0558",
            "fax_number": "253-841-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEU",
        "first_name": "RICK",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5038427",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.