Healthcare Provider Details

I. General information

NPI: 1760289276
Provider Name (Legal Business Name): YILIN LIU DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date: 10/10/2025
Reactivation Date: 07/09/2026

III. Provider practice location address

635 ALBANY STREET
BOSTON MA
02118
US

IV. Provider business mailing address

635 ALBANY ST
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-358-8300
  • Fax:
Mailing address:
  • Phone: 617-358-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: