Individual provider Active NPI

Herman G. T. Liem, D. D. S.

  • General Practice Dentistry
  • Gold Beach, OR
National Provider Identifier
1326031352
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6942 Issued in OR
Practice address
29814 N Ellensburg Ave
Gold Beach, OR 97444-1600
Phone
(541) 247-8000
Fax
(541) 247-8000
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 D6942 OR Primary

Addresses

Primary practice location

29814 N Ellensburg Ave
Gold Beach, OR 97444-1600

Mailing address

PO Box 1600
Gold Beach, OR 97444-1600
Phone (541) 247-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150721001957 OR Order and Referring Only - DentistPractitioner - Dentist 6103139076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dentistry of Gold Beach, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326031352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1600",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974441600",
            "telephone_number": "541-247-8000",
            "fax_number": "541-247-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29814 N ELLENSBURG AVE",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974441600",
            "telephone_number": "541-247-8000",
            "fax_number": "541-247-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEM",
        "first_name": "HERMAN",
        "middle_name": "G. T.",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Beach, OR

Sources for this page

Verify at the official NPI Registry.