Barry Dental Clinic

Primary specialty

DentistTaxonomy code 122300000X

License

019021224 Issued in IL

Legal business name

BARRY DENTAL CLINIC

Doing business as

Stephen T Liesen DMD LLC

Practice address

750 Mortimer St
Barry, IL 62312-1247

Phone

(217) 335-2397

Fax

(217) 335-2398

NPI assigned

Mar 19, 2008

Last updated

Oct 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen T Liesen, DMDNPI 1124009329

Title

Dentist/Owner

Phone

(217) 335-2397

Specialties & licenses 1

Addresses

Other names 1

• STEPHEN T LIESEN DMD LLC Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen T Liesen, DMD

  • Dentist
  • Barry, IL
  • NPI 1124009329
  NPD (past) Authorized official
• Brett R Schafer, DMD

  • Dentist
  • Barry, IL
  • NPI 1447597950
  NPD (past)

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1174794028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 MORTIMER ST",
            "city": "BARRY",
            "state": "IL",
            "postal_code": "623121247",
            "telephone_number": "217-335-2397",
            "fax_number": "217-335-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MORTIMER ST",
            "city": "BARRY",
            "state": "IL",
            "postal_code": "623121247",
            "telephone_number": "217-335-2397",
            "fax_number": "217-335-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "LIESEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "217-335-2397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019021224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEPHEN T LIESEN DMD LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sally E Artz, PTA
• Barry Comm Unit School Dist 1
• Barry Community Care Center, Inc
• Barry Dental Care PLCC
• Barry Healthcare and Senior Living LLC
• Dianna Michelle Castleberry
• Alyssa Garde, OTR/L
• Kristie Ann Haubrich
• Ruth A Holman, NP

• Dentist in Barry, IL
• Providers in Barry, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.