Individual provider Active NPI

Caci Irene Liebentritt, D.D.S.

  • Endodontics
  • Omaha, NE
National Provider Identifier
1942345392
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6128 Issued in NE
Practice address
15808 W Dodge Rd Ste 101
Omaha, NE 68118-2050
Phone
(402) 390-2020
Fax
(402) 397-3675
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 6128 NE Primary

Addresses

Primary practice location

15808 W Dodge Rd Ste 101
Omaha, NE 68118-2050

Mailing address

15808 W Dodge Rd Ste 101
Omaha, NE 68118-2050
Phone (402) 390-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6128NEMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Endodontists PC Endodontics CurrentSince Mar 11, 2025 Accepting new patients

Locations

15808 W Dodge Rd
Ste 101
Omaha, NE 68118
Phone (402) 390-2020

600 N 93rd St
Omaha, NE 68114
Phone (402) 390-2020

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1942345392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15808 W DODGE RD STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182050",
            "telephone_number": "402-390-2020",
            "fax_number": "402-397-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15808 W DODGE RD STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182050",
            "telephone_number": "402-390-2020",
            "fax_number": "402-397-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBENTRITT",
        "first_name": "CACI",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NE",
            "license": "6128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.