Individual provider Active NPI

Bobby Don Leach, D.D.S.

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1184780264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8450 Issued in TX
Practice address
2359 Gus Thomasson Rd
Dallas, TX 75228-3004
Phone
(214) 321-3434
Fax
(972) 516-3290
NPI assigned
Dec 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 8450 TX Primary

Addresses

Primary practice location

2359 Gus Thomasson Rd
Dallas, TX 75228-3004

Mailing address

2359 Gus Thomasson Rd
Dallas, TX 75228-3004
Phone (214) 321-3434

Other names 1

  • B. D. Leach Professional name

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

NPI Registry JSON

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184780264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2359 GUS THOMASSON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283004",
            "telephone_number": "214-321-3434",
            "fax_number": "972-516-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2359 GUS THOMASSON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283004",
            "telephone_number": "214-321-3434",
            "fax_number": "972-516-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "BOBBY",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "8450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "B.",
            "last_name": "LEACH",
            "middle_name": "D.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.