Individual provider Active NPI

Elizabeth Liu, DDS

  • General Practice Dentistry
  • Shenandoah, TX
National Provider Identifier
1962102178
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40524 Issued in TX
Practice address
1500 Research Forest Dr Ste 220
Shenandoah, TX 77381-7300
Phone
(281) 859-4624
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 40524 TX Primary

Addresses

Primary practice location

1500 Research Forest Dr Ste 220
Shenandoah, TX 77381-7300

Mailing address

1500 Research Forest Dr Ste 220
Shenandoah, TX 77381-7300
Phone (281) 859-4624

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
I20241001000496 TX Order and Referring Only - DentistPractitioner - Dentist 3274064399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Smiles Dentistry, PC PastSince Jun 30, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1962102178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 RESEARCH FOREST DR STE 220",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773817300",
            "telephone_number": "281-859-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 RESEARCH FOREST DR STE 220",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773817300",
            "telephone_number": "281-859-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "ELIZABETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.