Provider Demographics
NPI:1548142615
Name:MAH, LIANA (DMD)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:MAH
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 1:2000 METROPICA WAY APT 2404
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3228
Mailing Address - Country:US
Mailing Address - Phone:250-686-0158
Mailing Address - Fax:
Practice Address - Street 1:6536 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4001
Practice Address - Country:US
Practice Address - Phone:954-933-1705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL306111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice