Leandre Daniel Gervais, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN123399 Issued in GA

Practice address

1901 Phoenix Blvd Ste 100
College Park, GA 30349-5062

Phone

(770) 991-0913

NPI assigned

May 18, 2023

Last updated

Jun 3, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Leandre D Gervais Other name

Medicare fee-for-service enrollment

Enrolled in NC

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

Practice roles

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.

• Dental One Associates (College Park) LLC

  • Dentist
  • Atlanta, GA
  • NPI 1154454171
  NPD (past)

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1184315152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD, CHARLOTTE",
            "city": "ATLANTA",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2165",
            "fax_number": "704-355-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 PHOENIX BLVD STE 100",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495062",
            "telephone_number": "770-991-0913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-2165",
            "fax_number": "704-355-8856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "341 Ponce De Leon Ave NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303082012",
            "country_code": "US",
            "telephone_number": "404-616-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERVAIS",
        "first_name": "LEANDRE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123399",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "151483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANDRE",
            "last_name": "GERVAIS",
            "middle_name": "D",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Fulton County Board of Health (College Park Regional Health Center)
• Krystal S. Gambrell, SLP
• Sharon Ann Ganaway, CERTIFIED NURSE/TECH
• Georgia Clinics LLC
• Kylie Gerks, MS, MFT
• Tara Ann Gill, M.S.
• Devonte' L. Glass, DC
• Cynthia Glenn
• Godby Medical Equipment, LLC
• Gods Appointed Time Private Homecare

• Dentist in College Park, GA
• Providers in College Park, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.