Provider Demographics
NPI:1144844366
Name:LIEBERMAN, BRANDIN (DMD)
Entity type:Individual
Prefix:
First Name:BRANDIN
Middle Name:
Last Name:LIEBERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 SW 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5019
Mailing Address - Country:US
Mailing Address - Phone:954-907-0599
Mailing Address - Fax:
Practice Address - Street 1:11201 SHAKER BLVD STE 136
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-3833
Practice Address - Country:US
Practice Address - Phone:216-861-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.0042271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice