Individual provider Active NPI

Jeffrey James Lenius, D.D.S, M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • O Fallon, MO
National Provider Identifier
1134547474
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
812 Issued in KS
Practice address
3006 Highway K
O Fallon, MO 63368-8675
Phone
(636) 978-8848
Fax
(636) 294-4059
NPI assigned
Apr 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61712 KS
Dentist 122300000X DDS-08864 IA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2013043911 MO
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 812 KS Primary

Addresses

Primary practice location

3006 Highway K
O Fallon, MO 63368-8675

Mailing address

3006 Highway K
O Fallon, MO 63368-8675
Phone (636) 978-8848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20200130003234 KS Order and Referring Only - DentistPractitioner - Dentist 9830525302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
812KSMDCounseling Psychologist
DDS-08864IAMDDentist
2013043911MOMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lenius Orthodontics LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1134547474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688675",
            "telephone_number": "636-978-8848",
            "fax_number": "636-294-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688675",
            "telephone_number": "636-978-8848",
            "fax_number": "636-294-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENIUS",
        "first_name": "JEFFREY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61712",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-08864",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "2013043911",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KS",
            "license": "812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.