Provider Demographics
NPI:1619841368
Name:LIU, PRISCILLA (DDS)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3582 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-3357
Mailing Address - Country:US
Mailing Address - Phone:510-776-1513
Mailing Address - Fax:
Practice Address - Street 1:22535 2ND ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4111
Practice Address - Country:US
Practice Address - Phone:510-750-1654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist