Darryl Erik Lieberman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

044003 Issued in NY

Practice address

790 Concourse VLG W
Bronx, NY 10451-3804

Phone

(718) 538-6060

Fax

(718) 538-4833

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861541690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 CONCOURSE VLG W",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513804",
            "telephone_number": "718-538-6060",
            "fax_number": "718-538-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CONCOURSE VLG W",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513804",
            "telephone_number": "718-538-6060",
            "fax_number": "718-538-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "DARRYL",
        "middle_name": "ERIK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "044003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rudy Licul, RPH
• Angela Patricia Lide, LPN
• Alexandra Lieb, MD
• Lieberman and Barnett DDS PC
• Danielle Lieberman, DDS
• Heather Michele Lieberman, CNM
• Johanna Omark Lieberman, R.D.
• Joshua Matthew Lieberman, MD
• Rhonda J. Lieberman, LCSW-R
• Ralph William Liebling

• Dentist in Bronx, NY
• Providers in Bronx, NY by specialty
• Dentist 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.