Life Bridge Dental DC PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LIFE BRIDGE DENTAL DC PLLC

Doing business as

Tend Dental

Practice address

600 Pennsylvania Ave NW
Washington, DC 20580-0001

Phone

(212) 686-3686

Fax

(615) 468-0325

NPI assigned

Mar 18, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Neil Sullivan

Title

Director of Patient Revenue

Phone

(212) 686-3686

Specialties & licenses 1

Addresses

Other names 1

• Tend Dental Doing business as

Locations

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1174109425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 N CUMBERLAND AVE STE 307",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564761",
            "telephone_number": "212-686-3686",
            "fax_number": "615-468-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205800001",
            "telephone_number": "212-686-3686",
            "fax_number": "615-468-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE BRIDGE DENTAL DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT REVENUE",
        "authorized_official_telephone_number": "212-686-3686",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tend Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jane E Liedtka, MD
• Reine Kamtcheu Lienou
• Connie Jo Lierman, PNP
• Kelly Liesse, MD
• Samuel H Lievano, D.D.S
• Life Building Mission Inc
• Life Care Inc.
• Life Changing Solutions, LLC
• Life Enhancement Services
• Life Enhancement Services Mo LLC

• General Practice Dentistry in Washington, DC
• Providers in Washington, DC by specialty
• General Practice Dentistry in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.