Individual provider Active NPI

Kevin Liang, DDS

  • General Practice Dentistry
  • San Gabriel, CA
National Provider Identifier
1447802368
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104533 Issued in CA
Practice address
416 W Las Tunas Dr Ste 201
San Gabriel, CA 91776-1236
Phone
(626) 288-8376
NPI assigned
Jul 11, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 104533 CA Primary

Addresses

Primary practice location

416 W Las Tunas Dr Ste 201
San Gabriel, CA 91776-1236

Mailing address

416 W Las Tunas Dr Ste 201
San Gabriel, CA 91776-1236

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
I20210927001310 CA Practitioner - Dentist 5890192389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Donna J. Woo, D.D.S. Inc. CurrentSince Aug 1, 2021 Accepting new patients

Locations

420 S State College Blvd
Anaheim, CA 92806
Phone (714) 772-0770

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1447802368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR STE 201",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR STE 201",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-288-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIANG",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.