Individual provider Active NPI

Krystal Liu, DDS

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1801308267
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33453 Issued in TX
Practice address
9901 Palmbrook Dr
Austin, TX 78717-3993
Phone
(909) 533-1777
NPI assigned
Oct 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33453 TX Primary

Addresses

Primary practice location

9901 Palmbrook Dr
Austin, TX 78717-3993

Mailing address

9901 Palmbrook Dr
Austin, TX 78717-3993
Phone (909) 533-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20250815001568 TX Order and Referring Only - DentistPractitioner - Dentist 3375042518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33453TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1801308267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 PALMBROOK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787173993",
            "telephone_number": "909-533-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 PALMBROOK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787173993",
            "telephone_number": "909-533-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "KRYSTAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.