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General NPI Number Information
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NPI Number | 1184828089
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Entity Type | Individual
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Provider Name | LIANG REN DDS
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Gender | Male
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 1501 SUPERIOR AVE SUITE306
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3600
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Country | US
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Telephone | 949-218-1408
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Fax | 949-218-1410
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Provider Business Mailing Address
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Address Line | 1501 SUPERIOR AVE 306
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3600
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Country | US
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Telephone | 949-218-1408
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Fax | 949-218-1410
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 40113
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License Number State | CA
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