| Js Liu Dds Inc | |
|
9791 Baseline Road Rancho Cucamonga CA 91730 | |
| (909) 987-8779 | |
| (909) 987-2815 |
| Full Name | Js Liu Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 9791 Baseline Road, Rancho Cucamonga, California |
| Authorized Official Name and Position | Johnny Liu (DDS/OWNER) |
| Authorized Official Contact | 6263203611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Js Liu Dds Inc 9791 Baseline Road Rancho Cucamonga CA 91730 Ph: (909) 987-8779 | Js Liu Dds Inc 9791 Baseline Road Rancho Cucamonga CA 91730 Ph: (909) 987-8779 |
| NPI Number | 1629462031 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 03/02/2020 |
| Medicare PECOS PAC ID | 0143659482 |
|---|---|
| Medicare Enrollment ID | O20200407002785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629462031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 51966 (California) | Primary |
| Provider Name | Johnny S Liu |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1124127956 PECOS PAC ID: 1052740396 Enrollment ID: I20200407002937 |
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