Frederick Liu, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

04014143467 Issued in VA

Practice address

12359 Sunrise Valley Dr Ste 300
Reston, VA 20191-3463

Phone

(703) 385-5777

NPI assigned

Jan 13, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 13, 2017 through Feb 13, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Fairfax Oral and Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fairfax, VA
  • NPI 1710907134
  NPD (past)

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1336386325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 300",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-385-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 300",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-385-5777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6211 Centreville Rd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "VA",
            "postal_code": "201212635",
            "country_code": "US",
            "telephone_number": "703-266-0026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-13",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "04014143467",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101255779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Ling, PH.D.
• Nancy A. Linton, LPC
• Heidi Lisker, M.D.
• Darren S Lisse, MD
• Michael Edward Little Sr., DDS
• Liangxuan Liu
• Whitney Susan Livingston, PHD
• Llfaganmd LLC
• Kymberly Logar, LPC
• Amanda Bales Long, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Reston, VA
• Providers in Reston, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.