Individual provider Active NPI

Susan Yi Liu

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1588199491
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0598341 Issued in NY
Practice address
10 Waterside PLZ
Apt 9B
New York, NY 10010-2602
Phone
(646) 670-2801
NPI assigned
Apr 28, 2017
Last updated
Apr 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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 0598341 NY Primary

Addresses

Primary practice location

10 Waterside PLZ
Apt 9B
New York, NY 10010-2602

Mailing address

10 Waterside PLZ
Apt 9B
New York, NY 10010-2602
Phone (646) 670-2801

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
0598341NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1588199491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WATERSIDE PLZ",
            "address_2": "APT 9B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102602",
            "telephone_number": "646-670-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WATERSIDE PLZ",
            "address_2": "APT 9B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102602",
            "telephone_number": "646-670-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "SUSAN",
        "middle_name": "YI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0598341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.