Provider Demographics
NPI:1891473591
Name:LIANG, YONGXI (DMD)
Entity type:Individual
Prefix:
First Name:YONGXI
Middle Name:
Last Name:LIANG
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 1:601 ALBANY ST UNIT 208
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2790
Mailing Address - Country:US
Mailing Address - Phone:979-422-9632
Mailing Address - Fax:
Practice Address - Street 1:31515 PETE VON REICHBAUER WAY S UNIT 108
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5599
Practice Address - Country:US
Practice Address - Phone:253-444-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61460313122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist