Clifford G Lisman, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI010843 Issued in NJ

Practice address

320 South Main Street
Phillipsburg, NJ 08865-2824

Phone

(908) 387-6120

Fax

(908) 387-8322

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Clifford G Lisman Professional name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dental Health Associates PA

  • General Practice Dentistry
  • Phillipsburg, NJ
  • NPI 1477632289
  NPD (past) Authorized official

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1114014982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SOUTH MAIN STREET",
            "address_2": "2ND FLR",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "08865",
            "telephone_number": "908-387-6120",
            "fax_number": "908-387-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SOUTH MAIN STREET",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652824",
            "telephone_number": "908-387-6120",
            "fax_number": "908-387-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISMAN",
        "first_name": "CLIFFORD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI010843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLIFFORD",
            "last_name": "LISMAN",
            "middle_name": "G",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Karen Llanos, OTR, CHT
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• Lopatcong Chiropractic LLC

• Pediatric Dentistry in Phillipsburg, NJ
• Providers in Phillipsburg, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.