Adam David Lietzan, PHD, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

10709 Issued in NC

Practice address

111 Brauer Hall
Unc at Chapel Hill School of Dentistry - Dept of Perio
Chapel Hill, NC 27599-7450

Phone

(302) 381-5158

NPI assigned

Jun 30, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1982125837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 SOUTHPOINT TRL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BRAUER HALL",
            "address_2": "UNC AT CHAPEL HILL SCHOOL OF DENTISTRY - DEPT OF PERIO",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997450",
            "telephone_number": "302-381-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETZAN",
        "first_name": "ADAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PHD, DMD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10709",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "10709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven N Lichtman, MD
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• Miriam E. Lieberman, MA, LPC
• Elizabeth Louise Liepold, LCSW
• Life and Abundance Enterprises LLC
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• Amy Likamwa
• Kevin Lim, D.M.D.
• Moe R. Lim, MD

• Periodontics in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Periodontics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.