NPIMap

Organization Active NPI

Mark B Lieberman DDS Inc

  • Dental Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1316958929
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
22637 Issued in CA
Legal business name
MARK B LIEBERMAN DDS INC
Practice address
11645 Wilshire Blvd
Suite 1001
Los Angeles, CA 90025-1708
Phone
(310) 826-7863
Fax
(310) 820-6163
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark B Lieberman, DDSNPI 1174534788
Title
President
Phone
(310) 826-7863

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
Dental Clinic/Center 261QD0000X 22637 CA Primary

Addresses

Primary practice location

11645 Wilshire Blvd
Suite 1001
Los Angeles, CA 90025-1708

Mailing address

11645 Wilshire Blvd
Suite 1001
Los Angeles, CA 90025-1708
Phone (310) 826-7863

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316958929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 1001",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-826-7863",
            "fax_number": "310-820-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 1001",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-826-7863",
            "fax_number": "310-820-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK B LIEBERMAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-826-7863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "22637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.