Liska M Andu, DDS
Individual provider Active NPI Dentist · Woodstock, GA
NPI 1609052877 · NPPES record last updated Jan 17, 2008
Key facts
- NPI
- 1609052877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 011227 (GA)
- Practice address
- 5026 Winding Hills LN
Woodstock, GA 30189-2582 - Phone
- (770) 591-3947
- NPI assigned
- Jan 17, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011227 | GA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 011227 | GA | Yes |
Addresses
Primary practice location
5026 Winding Hills LN
Woodstock, GA 30189-2582
Mailing address
3525 Busbee Dr NW
Suite 200
Kennesaw, GA 30144-5511
Phone (678) 836-2115
Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.