Dr Jeremy John Liddiard, DMD - Medicare Dentist in Phoenix, AZ

Dr Jeremy John Liddiard, DMD is a medicare enrolled "Dentist" provider in Phoenix, Arizona. His current practice location is 12005 N Tatum Blvd, Suite 105, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 971-0026.

Dr Jeremy John Liddiard is licensed to practice in Arizona (license number D009550) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003269358.

Contact Information

Dr Jeremy John Liddiard, DMD
12005 N Tatum Blvd, Suite 105,
Phoenix, AZ 85028-1650
(602) 971-0026
Not Available



Healthcare Provider's Profile

Full NameDr Jeremy John Liddiard
GenderMale
SpecialityDentist
Location12005 N Tatum Blvd, Phoenix, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003269358
  • Provider Enumeration Date: 07/21/2016
  • Last Update Date: 07/21/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 4789972183
  • Enrollment ID: I20161018002695

Medical Identifiers

Medical identifiers for Dr Jeremy John Liddiard such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003269358NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist D009550 (Arizona)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jeremy John Liddiard is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jeremy John Liddiard, DMD
12005 N Tatum Blvd, Suite 105,
Phoenix, AZ 85028-1650

Ph: (602) 971-0026
Dr Jeremy John Liddiard, DMD
12005 N Tatum Blvd, Suite 105,
Phoenix, AZ 85028-1650

Ph: (602) 971-0026

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› Verified 5 days ago


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