Healthcare Provider Details

I. General information

NPI: 1598383267
Provider Name (Legal Business Name): TINGXI LIU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 06/25/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2833 CROOKS RD STE 103
TROY MI
48084-4732
US

IV. Provider business mailing address

2833 CROOKS RD STE 103
TROY MI
48084-4732
US

V. Phone/Fax

Practice location:
  • Phone: 248-649-2400
  • Fax:
Mailing address:
  • Phone: 248-885-4891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901600574
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: