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NPI Code Detail

MEDICARE: DR. XINYAN LIU DMD

MEDICARE: DR. XINYAN LIU 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
11223G0001XGeneral Practice DentistryDN1855149MA

General Provider Information

NPI Number : 1073741278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. XINYAN LIU DMD
Provider Business Mailing Address
First Line : 145 SOUTH ST
Second Line :
City : BOSTON
State : MA
Zip : 02111-2826
Country : US
Telephone Number : 617-521-6760
Fax Number : 617-457-6696
Provider Business Practice Location Address
First Line : 435 HANCOCK ST
Second Line :
City : QUINCY
State : MA
Zip : 02171-2428
Country : US
Telephone Number : 617-745-0280
Fax Number : 617-745-0288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2009
Last Update Date : 06/16/2012

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