Individual provider Active NPI

Landon Libby, D.D.S.

  • Dentist
  • La Mesa, CA
National Provider Identifier
1275816506
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60867 Issued in CA
Practice address
8555 Fletcher Pkwy
Suite 102
La Mesa, CA 91942-3060
Phone
(619) 337-7700
Fax
(619) 337-7710
NPI assigned
Sep 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60867 CA Primary

Addresses

Primary practice location

8555 Fletcher Pkwy
Suite 102
La Mesa, CA 91942-3060

Mailing address

8555 Fletcher Pkwy
Suite 102
La Mesa, CA 91942-3060
Phone (619) 337-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60867CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1275816506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 FLETCHER PKWY",
            "address_2": "SUITE 102",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423060",
            "telephone_number": "619-337-7700",
            "fax_number": "619-337-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8555 FLETCHER PKWY",
            "address_2": "SUITE 102",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423060",
            "telephone_number": "619-337-7700",
            "fax_number": "619-337-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "LANDON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.