NPIMap

Organization Active NPI

Shore Pediatric Dental Group

  • Dentist
  • Red Bank, NJ
National Provider Identifier
1730114232
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SHORE PEDIATRIC DENTAL GROUP
Practice address
152 Broad St
Red Bank, NJ 07701-2046
Phone
(732) 842-5577
Fax
(732) 842-8253
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Dr. William H Lieberman, DDSNPI 1326064221
Title
Owner
Phone
(732) 842-5577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

152 Broad St
Red Bank, NJ 07701-2046

Mailing address

152 Broad St
Red Bank, NJ 07701-2046
Phone (732) 842-5577

National Provider Directory

National Provider Directory

Locations

152 Broad St
Red Bank, NJ 07701
Phone (732) 842-5577

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1730114232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012046",
            "telephone_number": "732-842-5577",
            "fax_number": "732-842-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012046",
            "telephone_number": "732-842-5577",
            "fax_number": "732-842-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-842-5577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.