Liberty Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

040797-1 Issued in NY

Legal business name

LIBERTY ORAL SURGERY

Practice address

201 Edward Curry Ave Ste 101
Staten Island, NY 10314-7102

Phone

(718) 494-2053

NPI assigned

Nov 2, 2017

Organization subpart

No

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

Authorized official

Name

Stuard A Katz, DMD

Title

Co-Owner

Phone

(718) 494-2053

Specialties & licenses 1

Addresses

Other names 1

• Paramount Oral Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stuart Alan Katz, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Elmwood Park, NJ
  • NPI 1750377933

  NY

  Medicare reassignment NPD
• George Duncan Georgiev, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Staten Island, NY
  • NPI 1487207239
  NPD
• David Sheen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Staten Island, NY
  • NPI 1134506132
  NPD
• Adam Schuessler, D.M.D. M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Port Saint Lucie, FL
  • NPI 1083857221
  NPD (past)

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509580800000",
    "number": "1104338946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EDWARD CURRY AVE STE 101",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147102",
            "telephone_number": "718-494-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EDWARD CURRY AVE STE 101",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147102",
            "telephone_number": "718-494-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "STUARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "718-494-2053",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "040797-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paramount Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Liberman
• Laurel Liberman, L.C.S.W.
• Taly Liberman
• Maya Liberovich, RN
• Robert John Liberto, P.A.
• Brandon Liberzon, R.T.
• Serena Marie Licastro, L.MT
• Jeffrey Paul Licata, PA-C
• Stephen Licata, P.T.
• Francine Licausi, RN

• Oral and Maxillofacial Surgery (Dentist) in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.