Active NPI
Jess L. Liu, D.D.S
- Dentist
- Boston, MA
National Provider Identifier
1326277120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL12050
- Practice address
- 100 E Newton St
Suite 217
Boston, MA 02118-2308 - Phone
- (617) 638-4750
- NPI assigned
- Jul 14, 2009
- Last updated
- Sep 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 055051 | NY | |
| Dentist | 122300000X | DL12050 | MA | Primary |
Addresses
Primary practice location
100 E Newton St
Suite 217
Boston, MA 02118-2308
Mailing address
45 E Newton St
Apt 319
Boston, MA 02118-4802
Phone (917) 512-3055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150730011772 | MA | Order and Referring Only - Dentist | 9032423306 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL12050 | MA | MD | Dentist |
| 055051 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liu & Associates | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1326277120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 E NEWTON ST",
"address_2": "APT 319",
"city": "BOSTON",
"state": "MA",
"postal_code": "021184802",
"telephone_number": "917-512-3055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E NEWTON ST",
"address_2": "SUITE 217",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182308",
"telephone_number": "617-638-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "JESS",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-14",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "055051",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DL12050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.