NPIMap

Individual provider Active NPI

Megan Kathleen Lieberenz, D.D.S.

  • General Practice Dentistry
  • Las Cruces, NM
National Provider Identifier
1548522709
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD3672 Issued in NM
Practice address
530 N Telshor Blvd
Suite a
Las Cruces, NM 88011-8243
Phone
(505) 710-9434
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DD3672 NM Primary

Addresses

Primary practice location

530 N Telshor Blvd
Suite a
Las Cruces, NM 88011-8243

Mailing address

530 N Telshor Blvd
Suite a
Las Cruces, NM 88011-8243
Phone (505) 710-9434

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
DD3672NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Dental, PLLC PastSince Aug 2, 2020 Accepting new patients
Howard Dental, LLC PastSince Sep 20, 2022 Accepting new patients

Organizations & group practices 2

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1548522709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N TELSHOR BLVD",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118243",
            "telephone_number": "505-710-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N TELSHOR BLVD",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118243",
            "telephone_number": "505-710-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERENZ",
        "first_name": "MEGAN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.