Individual provider Active NPI

Edward Preston Liebersbach, D.D.S.

  • General Practice Dentistry
  • Rolling Hills Estates, CA
National Provider Identifier
1285894832
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32347 Issued in CA
Practice address
927 Deep Valley Dr
Ste 220
Rolling Hills Estates, CA 90274-3808
Phone
(310) 377-5566
Fax
(310) 377-5568
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 32347 CA Primary

Addresses

Primary practice location

927 Deep Valley Dr
Ste 220
Rolling Hills Estates, CA 90274-3808

Mailing address

927 Deep Valley Dr Ste 220
Rolling Hills Estates, CA 90274-3825
Phone (310) 377-5566

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
32347CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1285894832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 DEEP VALLEY DR STE 220",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743825",
            "telephone_number": "310-377-5566",
            "fax_number": "310-377-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 DEEP VALLEY DR",
            "address_2": "STE 220",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743808",
            "telephone_number": "310-377-5566",
            "fax_number": "310-377-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERSBACH",
        "first_name": "EDWARD",
        "middle_name": "PRESTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.