Dr Lawrence Elliott Liston, DDS in Bloomington, IL

Dr Lawrence Elliott Liston, DDS is a medicare enrolled "Dentist" provider in Bloomington, Illinois. His current practice location is 2103 E Washington St Ste 2d, Bloomington, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 663-5582.

Dr Lawrence Elliott Liston is licensed to practice in Illinois (license number 019019178) 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 1568616886.

Contact Information

	Dr Lawrence Elliott Liston, DDS
	2103 E Washington St Ste 2d, Bloomington, IL 61701-4365
	(309) 663-5582
	(309) 663-4683

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Lawrence Elliott Liston
Gender	Male
Speciality	Dentist
Location	2103 E Washington St Ste 2d, Bloomington, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1568616886
Provider Enumeration Date: 11/13/2008
Last Update Date: 11/13/2008

Medicare PECOS Information:

PECOS PAC ID: 4385032838
Enrollment ID: I20211102002263

Medical Identifiers

Medical identifiers for Dr Lawrence Elliott Liston such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568616886	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	019019178 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Lawrence Elliott Liston allows following entities to bill medicare on his behalf.

Entity Name	Macoupin County Public Health Department
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538444906 PECOS PAC ID: 1557377850 Enrollment ID: O20060223000446

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 Lawrence Elliott Liston 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 Address	Practice Location Address
Dr Lawrence Elliott Liston, DDS 2103 E Washington St Ste 2d, Bloomington, IL 61701-4365 Ph: (309) 663-5582	Dr Lawrence Elliott Liston, DDS 2103 E Washington St Ste 2d, Bloomington, IL 61701-4365 Ph: (309) 663-5582

Reviews and Comments

Dentist in Bloomington, IL

Dr. Michael Allen Pauley, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2103 E Washington St, Suite 3, Bloomington, IL 61701 Phone: 309-662-6660 Fax: 309-664-6044
Dr. Kirk William Noraian, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 105 N Williamsburg Dr, Bloomington, IL 61704 Phone: 309-663-4577 Fax: 306-663-2854
Brock Gardner, Dentist Medicare: Not Enrolled in Medicare Practice Location: 107 S Prospect Rd, Bloomington, IL 61704 Phone: 309-808-6263
Dr. Jack Capodice Jr., MD, DMD Dentist Medicare: Accepting Medicare Assignments Practice Location: 109 N Regency Dr, Bloomington, IL 61701 Phone: 309-663-2526 Fax: 309-663-4788
Johnny J Hernandez, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 10 Heartland Dr, Suite A, Bloomington, IL 61704 Phone: 309-662-0523 Fax: 309-662-7693
Dr. Uzma S. Hatia, DDS Dentist Medicare: Medicare Enrolled Practice Location: 507 N Hershey Rd Ste D, Bloomington, IL 61704 Phone: 309-661-0197 Fax: 309-663-0967
Dr. Bruce Woodruff Anderson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2310 E Oakland Ave Ste 13a, Bloomington, IL 61701 Phone: 309-662-1612 Fax: 309-662-0610

Dr Lawrence Elliott Liston, DDS - Medicare Dentist in Bloomington, IL