Justin Kimball Liddle, DMD, CDT

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

10142 Issued in CO

Practice address

2001 S Shields St Ste B1
Fort Collins, CO 80526-1829

Phone

(970) 224-4358

Fax

(970) 224-4388

NPI assigned

Jul 23, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1154634707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE B1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261829",
            "telephone_number": "970-224-4358",
            "fax_number": "970-224-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE B1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261829",
            "telephone_number": "970-224-4358",
            "fax_number": "970-224-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDLE",
        "first_name": "JUSTIN",
        "middle_name": "KIMBALL",
        "name_prefix": "Dr.",
        "credential": "DMD, CDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CO",
            "license": "10142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanfei Li, DPT
• Qinghua Liang, MD
• Joseph J Librizzi, LCSW
• Amy Marie Lichon, D.O.
• Hayley Liddle
• Deborah E Lieberman, PA-C
• Lesley Brooke Liebig, PHARM.D.
• Rayne Lieurance
• Life Cycle Counseling and Consulting, PLLC
• Lifescapes Counseling PLLC

• Prosthodontics in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Prosthodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.