Individual provider Active NPI

Angelica Sandra Leonardo

  • General Practice Dentistry
  • Cicero, NY
National Provider Identifier
1073194650
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
062518 Issued in NY
Practice address
8057 Brewerton Rd
Cicero, NY 13039-9585
Phone
(315) 698-0040
NPI assigned
Apr 15, 2021
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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 062518 NY Primary

Addresses

Primary practice location

8057 Brewerton Rd
Cicero, NY 13039-9585

Mailing address

9100 Claytonia Rd
Liverpool, NY 13090-1658
Phone (516) 710-8051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
062518NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Jose M Alvarez DDS PLLC General Practice CurrentSince Aug 7, 2022 Accepting new patients

Locations

8057 Brewerton Rd
Cicero, NY 13039
Phone (315) 698-0040

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1073194650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 CLAYTONIA RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901658",
            "telephone_number": "516-710-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8057 BREWERTON RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399585",
            "telephone_number": "315-698-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDO",
        "first_name": "ANGELICA",
        "middle_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.