Individual provider Active NPI

Kenneth Liszewski, DMD

  • Dentist
  • Sarasota, FL
National Provider Identifier
1467643239
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN0010939 Issued in FL
Practice address
1880 Arlington St
Ste 205
Sarasota, FL 34239
Phone
(941) 953-4288
Fax
(941) 953-2728
NPI assigned
Aug 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN0010939 FL Primary

Addresses

Primary practice location

1880 Arlington St
Ste 205
Sarasota, FL 34239

Mailing address

1880 Arlington St
Ste 205
Sarasota, FL 34239
Phone (941) 953-4288

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
DN0010939FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sarasota Dental Specialties PA Past Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1467643239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 ARLINGTON ST",
            "address_2": "STE 205",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-953-4288",
            "fax_number": "941-953-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 ARLINGTON ST",
            "address_2": "STE 205",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-953-4288",
            "fax_number": "941-953-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISZEWSKI",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0010939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.