MEDICARE: VIENNA LIU DDS

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
1	122300000X	Dentist	100308	CA

General Provider Information

NPI Number	:	1174975593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIENNA LIU DDS

Provider Business Mailing Address
First Line	:	457 BRIDLE CT
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94582-5950
Country	:	US
Telephone Number	:	925-699-6757
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 9TH ST STE 302
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94607-6523
Country	:	US
Telephone Number	:	510-986-6888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2016
Last Update Date	:	01/14/2026

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Directions to “ VIENNA LIU DDS” Practice Location

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