Provider Demographics
NPI:1407984289
Name:LIEMBERGER, JAMES NELSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NELSON
Last Name:LIEMBERGER
Suffix:
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 1:8262 OLD POST RD E
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1584
Mailing Address - Country:US
Mailing Address - Phone:716-741-9790
Mailing Address - Fax:716-741-5147
Practice Address - Street 1:8262 OLD POST RD E
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1584
Practice Address - Country:US
Practice Address - Phone:716-741-9790
Practice Address - Fax:716-741-5147
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0353811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00732018Medicaid