Organization Active NPI

Liberty Dental Care P.C.

  • General Practice Dentistry
  • South Richmond Hill, NY
National Provider Identifier
1003195298
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
053394 Issued in NY
Legal business name
LIBERTY DENTAL CARE P.C.
Practice address
11210 Liberty Ave
South Richmond Hill, NY 11419-1814
Phone
(718) 322-1415
Fax
(718) 880-2360
NPI assigned
Aug 5, 2011
Last updated
Aug 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sharla Seunarine, DDS
Title
Owner
Phone
(718) 322-1415

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 046341 NY
General Practice Dentistry 1223G0001X 053394 NY Primary

Addresses

Primary practice location

11210 Liberty Ave
South Richmond Hill, NY 11419-1814

Mailing address

112-10 Liberty Avenue
South Richmond Hill, NY 11419
Phone (718) 322-1415

Other identifiers 2

IdentifierTypeStateIssuer
02921479MedicaidNY
01742896MedicaidNY

National Provider Directory

National Provider Directory

Locations

11210 Liberty Ave
South Richmond Hill, NY 11419
Phone (718) 322-1415

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1003195298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112-10 LIBERTY AVENUE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "11419",
            "telephone_number": "718-322-1415",
            "fax_number": "718-880-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11210 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191814",
            "telephone_number": "718-322-1415",
            "fax_number": "718-880-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DENTAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-05",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "SEUNARINE",
        "authorized_official_first_name": "SHARLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-322-1415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046341",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02921479",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01742896",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.