Liberty Denture Clinic, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DT-DO-10122043 Issued in OR

Legal business name

LIBERTY DENTURE CLINIC, LLC

Practice address

1678 Liberty St SE
Suite #202
Salem, OR 97302-4348

Phone

(503) 363-0629

NPI assigned

May 22, 2010

Organization subpart

No

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

Authorized official

Name

Oswaldo Gonzalez Cantarero, LD

Title

Denturist

Phone

(503) 363-0629

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1274486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274486400000",
    "number": "1376862953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1678 LIBERTY ST SE",
            "address_2": "SUITE #202",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024348",
            "telephone_number": "503-363-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1678 LIBERTY ST SE",
            "address_2": "SUITE #202",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024348",
            "telephone_number": "503-363-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DENTURE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-22",
        "last_updated": "2010-05-22",
        "status": "A",
        "authorized_official_last_name": "CANTARERO",
        "authorized_official_first_name": "OSWALDO",
        "authorized_official_middle_name": "GONZALEZ",
        "authorized_official_title_or_position": "DENTURIST",
        "authorized_official_telephone_number": "503-363-0629",
        "authorized_official_credential": "LD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "DT-DO-10122043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Leann Li, LPC, CADC I
• Shangjian Li
• Sung Li, LMT
• Bushra Liaqat, DDS
• Liberty Dental Care PC
• Liberty House
• Liberty Mental Health Clinic
• Liberty Spine & Pain Center P C
• David Lichtenberger
• David John Lichter, MD

• Dental Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2010; 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.