Individual provider Active NPI

Ricky Lynn Leflore, D.D.S.

  • General Practice Dentistry
  • Garland, TX
National Provider Identifier
1194944215
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17958 Issued in TX
Practice address
4620 Northwest Hwy
Garland, TX 75043-4911
Phone
(972) 279-6569
Fax
(972) 279-8225
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
No

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 17958 TX Primary

Addresses

Primary practice location

4620 Northwest Hwy
Garland, TX 75043-4911

Mailing address

4620 Northwest Hwy
Garland, TX 75043-4911
Phone (972) 279-6569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160511001857 TX Order and Referring Only - DentistPractitioner - Dentist 0749579977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17958TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194944215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 NORTHWEST HWY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750434911",
            "telephone_number": "972-279-6569",
            "fax_number": "972-279-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 NORTHWEST HWY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750434911",
            "telephone_number": "972-279-6569",
            "fax_number": "972-279-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFLORE",
        "first_name": "RICKY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.