MEDICARE: FENG H LIU DENTAL INC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1255183612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FENG H LIU DENTAL INC

Provider Business Mailing Address
First Line	:	936 CRENSHAW BLVD # 100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1957
Country	:	US
Telephone Number	:	323-617-4180
Fax Number	:

Provider Business Practice Location Address
First Line	:	4627 SANTA MONICA BLVD STE D
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1831
Country	:	US
Telephone Number	:	323-560-2400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FENG LIU
Credential	:	DDS
Telephone Number	:	323-617-4180

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	05/09/2025

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Directions to “FENG H LIU DENTAL INC ” Practice Location

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