Adam Richard Van Leeuwen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6610915 Issued in UT

Practice address

6936 South 2475 East
201
Salt Lake City, UT 84121-5999

Phone

(801) 943-1612

Fax

(801) 942-6008

NPI assigned

Jul 23, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1003016536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6936 SOUTH 2475 EAST",
            "address_2": "201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841219999",
            "telephone_number": "801-943-1612",
            "fax_number": "801-942-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6936 SOUTH 2475 EAST",
            "address_2": "201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841215999",
            "telephone_number": "801-943-1612",
            "fax_number": "801-942-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN LEEUWEN",
        "first_name": "ADAM",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6610915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reed Patrick Van Hook, MD
• Kelsie Van Horn, DPT
• Kristy K. Van Katwyk, RN MSN FNP
• George Johan Van Komen, MD
• Van Leeuwen Dental, LLC
• Nicole Van Leeuwen
• Marticia Van Leuven
• Steven Burke Van Norman, MD
• Trishia Van Orden
• Christy Lynn Van Orman, FNP-C

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.