Individual provider Active NPI

Michael Steven Liss, DMD

  • Periodontics
  • Boca Raton, FL
National Provider Identifier
1396203485
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN13579 Issued in FL
Practice address
2600 N Military TRL Ste 310
Boca Raton, FL 33431-6315
Phone
(561) 997-4080
NPI assigned
Mar 7, 2019
Last updated
Mar 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DN13579 FL Primary

Addresses

Primary practice location

2600 N Military TRL Ste 310
Boca Raton, FL 33431-6315

Mailing address

2030 S Ocean Dr Apt 1714
Hallandale Beach, FL 33009-6613
Phone (561) 573-8741

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN13579FLMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dio Doctors PA PastSince Jul 28, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1396203485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 S OCEAN DR APT 1714",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330096613",
            "telephone_number": "561-573-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MILITARY TRL STE 310",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316315",
            "telephone_number": "561-997-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISS",
        "first_name": "MICHAEL",
        "middle_name": "STEVEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN13579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.