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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. RUSSELL ARON LIEBLICK DMD
NPI 1407856156
Dentist - Oral and Maxillofacial Surgery in Gresham, OR

Active since July 22, 2005Opted out of Medicare · through May 9, 2028
24850 SE STARK ST, SUITE 100, GRESHAM, OR 97030(503) 665-7882(503) 665-6983 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Russell Aron Lieblick Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RUSSELL ARON LIEBLICK DMD (NPI 1407856156) is an individual oral and maxillofacial surgery provider in Gresham, Oregon, licensed in Oregon (D8342) and active in the NPI registry since July 2005. He has opted out of Medicare through May 9, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1407856156
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. RUSSELL ARON LIEBLICKCredential: DMD
Location Address24850 SE STARK ST, SUITE 100Gresham, OR 97030-8316
Mailing Address24850 Se Stark St, Suite 100Gresham, OR 97030-8316 · (503) 665-7882 · Fax (503) 665-6983
Phone(503) 665-7882
Fax(503) 665-6983
Sole ProprietorNo
Enumeration DateJuly 22, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1407856156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in OR · D8342
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
24850 SE STARK ST, Gresham, OR 97030
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Russell Aron Lieblick Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 9, 2018 through May 9, 2028.

Opt-Out Effective DateMay 9, 2018
Opt-Out In Effect ThroughMay 9, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HENRY COOKE WINDELL DMD
Dentist (Oral and Maxillofacial Pathology)
24850 SE STARK ST
GRESHAM, OR 97030
Multnomah County (503) 665-7882
JUNE ELLEN HOBBS CNM
Advanced Practice Midwife
24850 SE STARK ST, SUITE 200
GRESHAM, OR 97030
Multnomah County (503) 491-9444
GRETCHEN ANN GROOMS LMT
Massage Therapist
24850 SE STARK ST, SUITE 200
GRESHAM, OR 97030
Multnomah County (503) 929-7220
DR. JULIA W MASON MD
Pediatrics
24850 SE STARK ST, SUITE 150
GRESHAM, OR 97030
Multnomah County (503) 491-0714
JENNIFER MARIE BOOM LMT
Massage Therapist
24850 SE STARK ST, SUITE 200
GRESHAM, OR 97030
Multnomah County (503) 310-2622
DR. JOHN ANTHONY CALCAGNO MD
Pediatrics
24850 SE STARK ST, STE 150
GRESHAM, OR 97030
Multnomah County (503) 491-0714
CALCAGNO PEDIATRICS PC
Pediatrics
24850 SE STARK ST, STE 150
GRESHAM, OR 97030
Multnomah County (503) 491-0714
DR. FRANK ANTHONY CALCAGNO MD
Pediatrics
24850 SE STARK ST, STE 150
GRESHAM, OR 97030
Multnomah County (503) 491-0714

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Lieblick's NPI number?

The NPI number for Russell Lieblick is 1407856156. It was assigned to this individual provider in the NPPES registry on July 22, 2005.

Where is Russell Lieblick located?

Russell Lieblick practices at 24850 SE Stark St Suite 100, Gresham, OR 97030. The listed phone number is (503) 665-7882.

What is Russell Lieblick's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Russell Lieblick enrolled in Medicare?

No. Russell Lieblick has opted out of Medicare through May 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Russell Lieblick was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.