Active NPI
Liem Duy DO, DDS
- General Practice Dentistry
- Vancouver, WA
National Provider Identifier
1568565950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE8159
- Practice address
- 13510 NE 84TH St
Suite #105
Vancouver, WA 98682-3092 - Phone
- (360) 696-0000
- Fax
- (360) 896-6264
- NPI assigned
- Sep 7, 2006
- 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 | DE8159 | WA | Primary |
Addresses
Primary practice location
13510 NE 84TH St
Suite #105
Vancouver, WA 98682-3092
Mailing address
13510 NE 84TH St
#105
Vancouver, WA 98682
Phone (360) 696-0000
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 |
|---|---|---|---|
| DE8159 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568565950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13510 NE 84TH ST",
"address_2": "#105",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98682",
"telephone_number": "360-696-0000",
"fax_number": "360-896-6264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13510 NE 84TH ST",
"address_2": "SUITE #105",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986823092",
"telephone_number": "360-696-0000",
"fax_number": "360-896-6264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DO",
"first_name": "LIEM",
"middle_name": "DUY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE8159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.