Mordecia Marc Liechtung, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

040754-1 Issued in NY

Practice address

1995 Broadway
Suite 200
New York, NY 10023-5882

Phone

(212) 247-2330

Fax

(212) 501-9471

NPI assigned

May 29, 2007

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

Other identifiers 1

Other names 1

• Marc Liechtung Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• East Side Esda Inc D/B/a East Side Dental Arts

  • General Practice Dentistry
  • New York, NY
  • NPI 1760155444
  NPD
• Mda Dental Group

  • Dentist
  • New York, NY
  • NPI 1619213436
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679774798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 85TH ST",
            "address_2": "APARTMENT #8F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280958",
            "telephone_number": "917-685-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 BROADWAY",
            "address_2": "SUITE 200",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235882",
            "telephone_number": "212-247-2330",
            "fax_number": "212-501-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIECHTUNG",
        "first_name": "MORDECIA",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040754-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METM LIFE DENTAL",
            "identifier": "134148576",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARC",
            "last_name": "LIECHTUNG",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeffrey Liebmann, MD
• Barry Liebowitz, M.D.
• Hana Liebowitz, DPT
• Jason Evan Liebowitz, M.D.
• Michael R Liebowitz, MD
• Benjamin L Liechty, MD
• Jessica Lieder, NP
• Marijeanne Liederbach
• Katherine A Liederman, LMSW
• Evelyn Rivia Lief, PH.D.

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.