Active NPI
Yijin Liu
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1417761925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 111880
- Practice address
- 520 E Manchester Ave
Los Angeles, CA 90003-3525 - Phone
- (323) 753-3000
- NPI assigned
- Feb 4, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 111880 | CA | Primary |
Addresses
Primary practice location
520 E Manchester Ave
Los Angeles, CA 90003-3525
Mailing address
301 Lodestar
Tustin, CA 92782-3756
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
| License | State | Type | Specialty |
|---|---|---|---|
| 111880 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752192000000",
"number": "1417761925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 LODESTAR",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927823756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 E MANCHESTER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900033525",
"telephone_number": "323-753-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "YIJIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-04",
"last_updated": "2025-07-11",
"certification_date": "2025-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "111880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.