Chun-Yu Liu
Individual provider Active NPI General Practice Dentistry · Swanton, OH
NPI 1700957339 · NPPES record last updated Apr 29, 2020
Key facts
- NPI
- 1700957339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 30-022331 (OH)
- Practice address
- 524 S Main St
Swanton, OH 43558-1451 - Phone
- (419) 825-1171
- Fax
- (419) 825-5424
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160620001828 | OH | Order and Referring Only - Dentist |
3375834526 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-022331 | OH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30-022331 | OH | Yes |
Addresses
Primary practice location
524 S Main St
Swanton, OH 43558-1451
Mailing address
524 S Main St
Swanton, OH 43558-1451
Phone (419) 825-1171
Other providers in Swanton, OH
- Penny Kay Jones
- Jaspreet Kaur
- Isaiah Kinkaid
- Brittany Leaser
- Lyn Lemon
- Courtney Evelyn Logan
- Cynthia Ann Long
- Lynn Lowery
- Kristi Mabie
- Majestic Care of Swanton LLC
All providers in Swanton, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.