Individual provider Active NPI

Brian Lehigh, DDS

  • Periodontics
  • Boulder, CO
National Provider Identifier
1215413356
Registry record updated May 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DEN.00203934 Issued in CO
Practice address
3400 Penrose PL Ste 103
Boulder, CO 80301-1809
Phone
(303) 449-1301
Fax
(303) 449-1331
NPI assigned
Jul 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 100523 CA
Periodontics 1223P0300X DEN.00203934 CO Primary

Addresses

Primary practice location

3400 Penrose PL Ste 103
Boulder, CO 80301-1809

Mailing address

4558 W 172ND St Apt 1
Lawndale, CA 90260-3413
Phone (303) 249-5605

Other practice location 1

4558 W 172nd St Apt 1
Lawndale, CA 90260-3413
Phone (303) 249-5605

Other practice location 2

11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone (310) 478-3711 ext. 41076

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

State licenses

LicenseStateTypeSpecialty
100523CAMDMarriage & Family Therapist
DEN.00203934COMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558828800000",
    "number": "1215413356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4558 W 172ND ST APT 1",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603413",
            "telephone_number": "303-249-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 PENROSE PL STE 103",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011809",
            "telephone_number": "303-449-1301",
            "fax_number": "303-449-1331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4558 W 172nd St Apt 1",
            "address_purpose": "LOCATION",
            "city": "Lawndale",
            "state": "CA",
            "postal_code": "902603413",
            "country_code": "US",
            "telephone_number": "303-249-5605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11301 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900731003",
            "country_code": "US",
            "telephone_number": "310-478-3711 x41076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEHIGH",
        "first_name": "BRIAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2019-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "100523",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "DEN.00203934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2019; 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.