Provider Demographics
NPI:1053601401
Name:LIU, STANLEY YUNG-CHUAN (MD, DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY YUNG-CHUAN
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:YUNG-CHUAN
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, DDS
Mailing Address - Street 1:3300 S. UNIVERSITY DRIVE
Mailing Address - Street 2:NSU FLORIDA, DEPT. OF ORAL & MAXILLOFACIAL SURGERY
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2004
Mailing Address - Country:US
Mailing Address - Phone:954-262-7332
Mailing Address - Fax:
Practice Address - Street 1:3300 S. UNIVERSITY DRIVE
Practice Address - Street 2:NSU FLORIDA, DEPT. OF ORAL & MAXILLOFACIAL SURGERY
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33328-2004
Practice Address - Country:US
Practice Address - Phone:954-262-7332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122495207Y00000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology