NPIMap

Organization Active NPI

North Liberty Dental Services P.C.

  • Dentist
  • North Liberty, IA
National Provider Identifier
1245407444
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
07594 Issued in IA
Legal business name
NORTH LIBERTY DENTAL SERVICES P.C.
Practice address
525 W Cherry St
North Liberty, IA 52317-9797
Phone
(319) 626-2300
Fax
(319) 626-3503
NPI assigned
May 15, 2008
Last updated
May 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Debra Beireis Carneol, DDSNPI 1215089149
Title
Owner
Phone
(319) 626-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 07594 IA Primary

Addresses

Primary practice location

525 W Cherry St
North Liberty, IA 52317-9797

Mailing address

525 W Cherry St
North Liberty, IA 52317-9797
Phone (319) 626-2300

Other identifiers 2

IdentifierTypeStateIssuer
49921OtherIAFEDERAL ID
0179390MedicaidIA

National Provider Directory

National Provider Directory

Locations

525 W Cherry St
North Liberty, IA 52317
Phone (319) 621-1507

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1245407444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W CHERRY ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179797",
            "telephone_number": "319-626-2300",
            "fax_number": "319-626-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W CHERRY ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179797",
            "telephone_number": "319-626-2300",
            "fax_number": "319-626-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LIBERTY DENTAL SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "CARNEOL",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "BEIREIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-626-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "07594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL ID",
            "identifier": "49921",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0179390",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.