Individual provider Active NPI

Bradley James Leiker, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • The Woodlands, TX
National Provider Identifier
1235256579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
16516 Issued in TX
Practice address
4840 W Panther Creek Dr
Suite #211
The Woodlands, TX 77381-3527
Phone
(281) 298-9434
Fax
(281) 298-6469
NPI assigned
Mar 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 16516 TX Primary

Addresses

Primary practice location

4840 W Panther Creek Dr
Suite #211
The Woodlands, TX 77381-3527

Mailing address

4840 W Panther Creek Dr
Suite #211
The Woodlands, TX 77381-3527
Phone (281) 298-9434

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16516TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235256579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 W PANTHER CREEK DR",
            "address_2": "SUITE #211",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773813527",
            "telephone_number": "281-298-9434",
            "fax_number": "281-298-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 W PANTHER CREEK DR",
            "address_2": "SUITE #211",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773813527",
            "telephone_number": "281-298-9434",
            "fax_number": "281-298-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIKER",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "16516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, 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.