Individual provider Active NPI

Donald A Liebers, DDS

  • Dentist
  • Schenectady, NY
National Provider Identifier
1710076583
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
041466 Issued in NY
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

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01096524MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170307000771 NY Order and Referring Only - DentistPractitioner - Dentist 3870485006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041466NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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.

FacilityTypeRoleSince
Hometown Health CentersSchenectady, NY, CCN 331833 Federally qualified health center Corporate Director May 24, 2007
Hometown Health Centers at AmsterdamAmsterdam, NY, CCN 571084 Federally qualified health center Corporate Director Oct 20, 2014
Hometown Health Centers Dental at State StreetSchenectady, NY, CCN 331803 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.

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": "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

Verify at the official NPI Registry.