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General NPI Number Information
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NPI Number | 1104718790
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Entity Type | Individual
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Provider Name | NOAH LIU
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Gender | Male
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 12050 VENTURA BLVD STE C101
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City | STUDIO CITY
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State | CA
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Zip | 91604-2639
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Country | US
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Telephone | 818-296-9142
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Fax |
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Provider Business Mailing Address
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Address Line | 2283 S ALTON WAY
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City | DENVER
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State | CO
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Zip | 80231-3476
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 111920
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License Number State | CA
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