Active NPI
Leonard Robert Buckheit II, DDS
- Dentist
- Baltimore, MD
National Provider Identifier
1184806408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6387
- Practice address
- 4102 Falls Rd
Baltimore, MD 21211-1641 - Phone
- (410) 235-1299
- NPI assigned
- Nov 28, 2007
- Last updated
- Nov 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6387 | MD | Primary |
Addresses
Primary practice location
4102 Falls Rd
Baltimore, MD 21211-1641
Mailing address
4102 Falls Rd
Baltimore, MD 21211-1641
Phone (410) 235-1299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 20, 2016 through May 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6387 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1184806408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 FALLS RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111641",
"telephone_number": "410-235-1299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 FALLS RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111641",
"telephone_number": "410-235-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKHEIT",
"first_name": "LEONARD",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-28",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "6387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.