Liberty Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61706 Issued in CA

Legal business name

LIBERTY DENTAL GROUP

Practice address

6440 Brentwood Blvd
Suite B
Brentwood, CA 94513-5789

Phone

(925) 634-3501

Fax

(925) 634-1539

NPI assigned

Nov 2, 2016

Last updated

Nov 2, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Emily Tung, DDSNPI 1013264563

Title

Owner

Phone

(310) 415-3866

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emily Tung, DDS

  • General Practice Dentistry
  • Brentwood, CA
  • NPI 1013264563
  NPD (past) Authorized official
• R. Paul Krey, DDS

  • Dentist
  • Brentwood, CA
  • NPI 1518970060
  NPD (past)
• Thomas R Greene

  • General Practice Dentistry
  • Dripping Springs, TX
  • NPI 1821105388
  NPD (past)

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1477005767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 BRENTWOOD BLVD",
            "address_2": "SUITE B",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135789",
            "telephone_number": "925-634-3501",
            "fax_number": "925-634-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 BRENTWOOD BLVD",
            "address_2": "SUITE B",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135789",
            "telephone_number": "925-634-3501",
            "fax_number": "925-634-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "TUNG",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-415-3866",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Leong, O.D.
• Veronica Lewis, OTA
• Chao Li
• Darin Li, DPT
• Weixing Li
• Liberty Dental Group
• Liberty Union High School District
• Joshua Lieberwirth
• Lift & Transfer Specialists, Inc.
• Nathaniel Liggins Jr.

• General Practice Dentistry in Brentwood, CA
• Providers in Brentwood, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.