Gregory David Liska, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9376 Issued in MN

Practice address

1025 Evergreen LN N
Plymouth, MN 55441-4800

Phone

(763) 546-2209

Fax

(763) 546-9107

NPI assigned

Jul 27, 2006

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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881618296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 EVERGREEN LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554414800",
            "telephone_number": "763-546-2209",
            "fax_number": "763-546-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 EVERGREEN LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554414800",
            "telephone_number": "763-546-2209",
            "fax_number": "763-546-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISKA",
        "first_name": "GREGORY",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Lindsay, CRNA
• David N Lippitt, PH.D., L.M.F.T.
• Leandro Michael Lira, D.D.S.
• Lisa Cross, Ma, LMFT, LLC
• Alda L Lisk
• Joe Litsey, PHARM.D.
• Andrew Yongkun Liu
• Jessica Liu
• Living Well Chiropractic, P.C.
• Living Well Chiropractic, P.C.

• General Practice Dentistry in Plymouth, MN
• Providers in Plymouth, MN by specialty
• General Practice Dentistry in Minnesota

• 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.