Matthew C. Lieto, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901020272 Issued in MI

Practice address

255 Washington St SE
Grand Rapids, MI 49503-4350

Phone

(616) 451-2336

Fax

(616) 222-1345

NPI assigned

Aug 19, 2010

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 MI

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": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1992011647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034350",
            "telephone_number": "616-451-2336",
            "fax_number": "616-222-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034350",
            "telephone_number": "616-451-2336",
            "fax_number": "616-222-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETO",
        "first_name": "MATTHEW",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Lienhart Liebbe, LLMSW
• Kimberly Katherine Liepold
• Mary B Lier, LMSW
• Emily Page Liescheidt
• Ann Marie Lietaert, CRNA
• David Francis Lieuwen, M.D.
• Suzanne Lieuwen, MSW, MPH
• Life Change Therapy LLC
• Life EMS Inc
• Life Guidance Services

• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.