Provider Demographics
NPI:1316642952
Name:LIU, MAX (DDS)
Entity type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GRANDVIEW
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0222
Mailing Address - Country:US
Mailing Address - Phone:949-981-8891
Mailing Address - Fax:
Practice Address - Street 1:110 BERGEN ST RM B-854
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2495
Practice Address - Country:US
Practice Address - Phone:972-972-3126
Practice Address - Fax:972-972-7322
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03059300390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program