Individual provider Active NPI

Leona Sperrazza, DDS

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1013168996
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS028617L Issued in PA
Practice address
3223 N Broad St
Philadelphia, PA 19140-5007
Phone
(215) 707-2995
Fax
(215) 707-0515
NPI assigned
Oct 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS028617L PA Primary

Addresses

Primary practice location

3223 N Broad St
Philadelphia, PA 19140-5007

Mailing address

3223 N Broad St
Philadelphia, PA 19140-5007
Phone (215) 707-2995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20231215000564 PA Order and Referring Only - DentistPractitioner - Dentist 6608193198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS028617LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1013168996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-2995",
            "fax_number": "215-707-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-2995",
            "fax_number": "215-707-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERRAZZA",
        "first_name": "LEONA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS028617L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.