NPIMap

Organization Active NPI

Donald R. Liberty, DDS, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • El Dorado Hills, CA
National Provider Identifier
1912281098
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
53466 Issued in CA
Legal business name
DONALD R. LIBERTY, DDS, INC.
Doing business as
Golden Foothills Oral and Facial Surgery Center
Practice address
4913 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9636
Phone
(916) 941-9860
Fax
(916) 941-7165
NPI assigned
Oct 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Authorized official

Name
Dr. Donald Robert Liberty, D.D.S.NPI 1306924980
Title
President
Phone
(916) 941-9860

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 53466 CA Primary

Addresses

Primary practice location

4913 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9636

Mailing address

4913 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9636
Phone (916) 941-9860

Other names 1

  • Golden Foothills Oral and Facial Surgery Center Doing business as

National Provider Directory

National Provider Directory

Locations

4913 Golden Foothill Pkwy
El Dorado Hills, CA 95762
Phone (530) 556-4810

Practitioners & affiliated clinicians

Practitioners 1

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": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1912281098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 GOLDEN FOOTHILL PKWY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629636",
            "telephone_number": "916-941-9860",
            "fax_number": "916-941-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4913 GOLDEN FOOTHILL PKWY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629636",
            "telephone_number": "916-941-9860",
            "fax_number": "916-941-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD R. LIBERTY, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "LIBERTY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-941-9860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "53466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Foothills Oral and Facial Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.