Charles(Chiaho) Liu, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-02-20402 Issued in OH

Practice address

2558 W 4TH St
Ontario, OH 44906-1209

Phone

(419) 683-3131

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1809/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1639103724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 W 4TH ST",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061209",
            "telephone_number": "419-683-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2558 W 4TH ST",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061209",
            "telephone_number": "419-683-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "CHARLES(CHIAHO)",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "20402",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-02-20402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199404",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Lee, DDS
• Hannah Leon
• Katrina Lewis
• Irene I Lin, DDS
• Lincare Inc
• Mary Lofreso
• Chelsi Renee Lohr
• Gordon David Long, M.D.
• Jodi L Ludwick, RPH
• Luxottica of America Inc (Target Optical #2042)

• General Practice Dentistry in Ontario, OH
• Providers in Ontario, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.