Provider Demographics
NPI:1114298072
Name:LINEBERGER, ADRIAN SMITH IV (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:SMITH
Last Name:LINEBERGER
Suffix:IV
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8817 SIX FORKS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2970
Mailing Address - Country:US
Mailing Address - Phone:919-848-3636
Mailing Address - Fax:
Practice Address - Street 1:8817 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2970
Practice Address - Country:US
Practice Address - Phone:919-848-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC92401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice