Individual provider Active NPI

Winston Liu

  • General Practice Dentistry
  • Golden Valley, MN
National Provider Identifier
1528427721
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D13860 Issued in MN
Practice address
4800 Olson Memorial Hwy Ste 110
Golden Valley, MN 55422-0717
Phone
(763) 544-0121
NPI assigned
Feb 16, 2016
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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 D13860 MN Primary

Addresses

Primary practice location

4800 Olson Memorial Hwy Ste 110
Golden Valley, MN 55422-0717

Mailing address

4800 Olson Memorial Hwy Ste 110
Golden Valley, MN 55422-0717
Phone (763) 544-0121

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

LicenseStateTypeSpecialty
D13860MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1528427721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 OLSON MEMORIAL HWY STE 110",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554220717",
            "telephone_number": "763-544-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OLSON MEMORIAL HWY STE 110",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554220717",
            "telephone_number": "763-544-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "WINSTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-16",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.

Verify at the official NPI Registry.