Russell Aron Lieblick, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D8342 Issued in OR

Practice address

24850 SE Stark St
Suite 100
Gresham, OR 97030-8316

Phone

(503) 665-7882

Fax

(503) 665-6983

NPI assigned

Jul 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 9, 2018 through May 9, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northwest Oral and Maxillofacial Surgeons

  • Oral and Maxillofacial Surgery (Dentist)
  • Gresham, OR
  • NPI 1417385857
  NPD (past) Authorized official
• Northwest Oral & Maxillofacial Surgeons, LLC

  • Oral and Maxillofacial Pathology Dentistry
  • Gresham, OR
  • NPI 1629286273
  NPD (past)

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407856156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24850 SE STARK ST",
            "address_2": "SUITE 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308316",
            "telephone_number": "503-665-7882",
            "fax_number": "503-665-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24850 SE STARK ST",
            "address_2": "SUITE 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308316",
            "telephone_number": "503-665-7882",
            "fax_number": "503-665-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBLICK",
        "first_name": "RUSSELL",
        "middle_name": "ARON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D8342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Lea Lewis
• Erica Michelle Lewis, RDH, BS,LAP
• Shannon Lorraine Lewis, CRM
• Kassandra Leyva
• Yale Liang, MD
• Lisa Lien, IBCLC
• Kimberly Anne Liepold, NP
• Aaron Michael Liere
• Lifespan Psychiatric Consulting, LLC
• Michael David Lifson, DO

• Oral and Maxillofacial Surgery (Dentist) in Gresham, OR
• Providers in Gresham, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.