Active NPI
Donald A Liebers, DDS
- Dentist
- Schenectady, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 041466
- Practice address
- 1070 Nott St
Schenectady, NY 12308-2410 - Phone
- (518) 374-4118
- Fax
- (518) 374-1978
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 041466 | NY | Primary |
Addresses
Primary practice location
1070 Nott St
Schenectady, NY 12308-2410
Mailing address
1070 Nott St
Schenectady, NY 12308-2410
Phone (518) 374-4118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01096524 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170307000771 | NY | Order and Referring Only - Dentist | 3870485006 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041466 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Offices, LLP | Past | Accepting new patients |
Ownership & related parties
All facility ownership & control disclosures 3
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Hometown Health Centers | Federally qualified health center | Corporate Director | May 24, 2007 |
| Hometown Health Centers at Amsterdam | Federally qualified health center | Corporate Director | Oct 20, 2014 |
| Hometown Health Centers Dental at State Street | Federally qualified health center | Corporate Director | Oct 20, 2014 |
Owned or controlled facilities with NPI records 3
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Family Medicine Physician
- Amsterdam, NY
- NPI 1174947469
Corporate Director
-
- Family Medicine Physician
- Schenectady, NY
- NPI 1396711982
Corporate Director
-
- Dental Clinic/Center
- Schenectady, NY
- NPI 1457024218
Corporate Director
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Schenectady, NY
- NPI 1164464848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1710076583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 NOTT ST",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123082410",
"telephone_number": "518-374-4118",
"fax_number": "518-374-1978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1070 NOTT ST",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123082410",
"telephone_number": "518-374-4118",
"fax_number": "518-374-1978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERS",
"first_name": "DONALD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "041466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01096524",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Schenectady, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.