MEDICARE: DR. TINA JIAQI LIANG DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7359	NV

General Provider Information

NPI Number	:	1134747298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA JIAQI LIANG DMD

Provider Business Mailing Address
First Line	:	8612 WIND ROSE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6863
Country	:	US
Telephone Number	:	702-885-6611
Fax Number	:

Provider Business Practice Location Address
First Line	:	6925 S BUFFALO DR
Second Line	:	ST 160
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2378
Country	:	US
Telephone Number	:	702-721-9698
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2020
Last Update Date	:	10/06/2025

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