Samson Liu, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

200164557 Issued in MO

Practice address

810 O'Fallon Rd
Weldon Springs, MO 63304-6330

Phone

(636) 244-4052

Fax

(636) 244-3850

NPI assigned

Feb 5, 2007

Last updated

Feb 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soh of Missouri Samson Liu PC

  dba Discovery Dental Center

  • Dentist
  • Saint Peters, MO
  • NPI 1013820166
  Authorized official Same address or phone
• Soh of Missouri Samson Liu PC

  dba Lindbergh Dental & Orthodontics

  • Dentist
  • Weldon Spring, MO
  • NPI 1427550078
  NPD (past) Authorized official
• Soh of Missouri Samson Liu PC

  dba Weldon Spring Dental

  • General Practice Dentistry
  • Weldon Spring, MO
  • NPI 1538661087
  Authorized official Same address or phone
• Soh of Missouri Samson Liu PC

  dba Weldon Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Weldon Spring, MO
  • NPI 1649878034
  Authorized official Same address or phone
• Soh of Texas Specialty Services PLLC

  dba Bunn Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Antonio, TX
  • NPI 1982368841
  Authorized official Same address or phone
• Soh of Missouri Samson Liu PC

  dba Plaza Dental Group

  • General Practice Dentistry
  • Columbia, MO
  • NPI 1528628716
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1568501955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 ELBRIDGE PAYNE RD, STE 240",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171138",
            "telephone_number": "636-362-4986",
            "fax_number": "636-778-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 O'FALLON RD",
            "city": "WELDON SPRINGS",
            "state": "MO",
            "postal_code": "633046330",
            "telephone_number": "636-244-4052",
            "fax_number": "636-244-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5133 S Campbell Ave",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658102406",
            "country_code": "US",
            "telephone_number": "417-886-1010",
            "fax_number": "417-886-1216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "346 Fort Zumwalt Sq",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633663065",
            "country_code": "US",
            "telephone_number": "314-753-8154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "SAMSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "200164557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405172701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Brockmeyer
• Karen Robinson
• Adrienne Wallace

• Dentist in Weldon Springs, MO
• Providers in Weldon Springs, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.

Verify at the official NPI Registry.