NPIMap

Individual provider Active NPI

Laura Liu, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lisle, IL
National Provider Identifier
1891358545
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021.002894 Issued in IL
Practice address
3060 Ogden Ave Ste 210
Lisle, IL 60532-1685
Phone
(630) 357-0002
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.030250 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021.002894 IL Primary

Addresses

Primary practice location

3060 Ogden Ave Ste 210
Lisle, IL 60532-1685

Mailing address

3060 Ogden Ave Ste 210
Lisle, IL 60532-1685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.030250ILMDGeneral Practice Dentistry
021.002894ILMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1891358545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 OGDEN AVE STE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 OGDEN AVE STE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321685",
            "telephone_number": "630-357-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.030250",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021.002894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.