David Ray Libby, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

1154-64 Issued in MS

Practice address

7732 Airways Blvd
Southaven, MS 38671-5306

Phone

(662) 349-0777

Fax

(662) 349-0782

NPI assigned

Jan 22, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Southern Orthodontic Specialists, P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Southaven, MS
  • NPI 1801921614
  NPD (past) Authorized official

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1194056648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7732 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715306",
            "telephone_number": "662-349-0777",
            "fax_number": "662-349-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7732 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715306",
            "telephone_number": "662-349-0777",
            "fax_number": "662-349-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "DAVID",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MS",
            "license": "1154-64",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS1639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Sheldon Leonard, PH.D.
• Lexi Caviness Lerossignol, PLPC
• Sharon Letson, RBT
• Christopher Randal Lewis, PHARM.D, MBA
• Patricia Leanne Lewis, FNP-C
• Linda a Foster MD PC
• Shirley B Lindsey, FNP
• Michael Alexander Lineberry, OTR/L
• Sonja Lipman
• Kristy Jo Lis, PLPC

• Orthodontics and Dentofacial Orthopedics Dentistry in Southaven, MS
• Providers in Southaven, MS by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

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