Provider Demographics
NPI:1538944582
Name:LIU, VICTORIA LIQ (DMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LIQ
Last Name:LIU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 BLUFFSIDE DR APT 305
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3373
Mailing Address - Country:US
Mailing Address - Phone:203-823-0209
Mailing Address - Fax:
Practice Address - Street 1:303 S GLENOAKS BLVD STE 12
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1184
Practice Address - Country:US
Practice Address - Phone:818-884-6285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1091891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice