Gregg A. Liedtka, D.M.D.

General Practice Dentistry · Moses Lake, WA

Individual Active NPI

NPI number 1619044286

Practice location

605 S Coolidge St
Moses Lake, WA 98837
Phone
(509) 765-0674
Fax
(506) 765-6591

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NPI record

NPI
1619044286
Entity type
Individual (Type 1)
Enumeration date
November 29, 2006
Last updated
June 21, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X DE00010090 WA

Mailing address

2034 E 63rd Ave
Spokane, WA 99223-8436
Phone
(509) 855-3946

About Dr. Liedtka

Gregg A. Liedtka, D.M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 605 S Coolidge St, Moses Lake, WA 98837. The NPI number 1619044286 was assigned on November 29, 2006 and the record was last updated on June 21, 2018.

Dr. Liedtka lists a license in the registry: #DE00010090 (WA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gregg A. Liedtka, D.M.D.?

The NPI number is 1619044286.

What is the phone number of Dr. Liedtka?

The phone number listed for the practice location is (509) 765-0674.

Where is Dr. Liedtka located?

605 S Coolidge St, Moses Lake, WA 98837.

What is the taxonomy code for Dr. Liedtka?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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