Watchung Avenue Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02414100 Issued in NJ

Legal business name

WATCHUNG AVENUE DENTAL LLC

Practice address

445 Watchung Ave
Watchung, NJ 07069-4956

Phone

(908) 222-0007

NPI assigned

Jun 9, 2014

Last updated

Jun 9, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lori Liu, DMD

Title

Member-Manager

Phone

(908) 222-0007

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diana Liu, D.M.D.

  • Dentist
  • Watchung, NJ
  • NPI 1790182764
  NPD (past)

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1699188417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WATCHUNG AVE",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070694956",
            "telephone_number": "908-222-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WATCHUNG AVE",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070694956",
            "telephone_number": "908-222-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATCHUNG AVENUE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "MEMBER-MANAGER",
        "authorized_official_telephone_number": "908-222-0007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02414100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Watchung, NJ
• Providers in Watchung, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.