Jacqueline Nicole Liu

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401418704 Issued in VA

Practice address

6204 Little River Tpke
Alexandria, VA 22312-1714

Phone

(703) 420-1079

NPI assigned

Mar 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 and National Provider Directory roles.

• Let'S Smile of Landmark PLLC

  • Dentist
  • Alexandria, VA
  • NPI 1407449226
  NPD (past)

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729900800000",
    "number": "1669930962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8190 STRAWBERRY LN APT N513",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421021",
            "telephone_number": "203-715-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6204 LITTLE RIVER TPKE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121714",
            "telephone_number": "703-420-1079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Cornerside Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221822434",
            "country_code": "US",
            "telephone_number": "703-821-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401418704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Listening Ears Audiology, LLC
• Kerry Ann O'Shea Litonjua, BCBA, M.ED.
• Emily Litten, PA-C
• Little Dental Studio, P.C.
• Jennifer L Little, AUD, CCC-A
• Wei Liu, M.D.
• Yan Liu, M.D.
• Live Well Home Care LLC
• Living Beyond Solutions LLC
• Living Well Home Care LLC

• Pediatric Dentistry in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; 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.