Individual provider Active NPI

Adam Joseph Diliberto, D.D.S.

  • Endodontics
  • Swansea, IL
National Provider Identifier
1285898262
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
019-026994 Issued in IL
Practice address
16 Park PL
Suite B
Swansea, IL 62226-2928
Phone
(618) 234-5533
Fax
(618) 234-8248
NPI assigned
Jul 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 019-026994 IL Primary

Addresses

Primary practice location

16 Park PL
Suite B
Swansea, IL 62226-2928

Mailing address

16 Park PL
Suite B
Swansea, IL 62226-2928
Phone (618) 234-5533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150303002418 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3971829243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-026994ILMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1285898262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PARK PL",
            "address_2": "SUITE B",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262928",
            "telephone_number": "618-234-5533",
            "fax_number": "618-234-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 PARK PL",
            "address_2": "SUITE B",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262928",
            "telephone_number": "618-234-5533",
            "fax_number": "618-234-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILIBERTO",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "019-026994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

Verify at the official NPI Registry.