Individual provider Active NPI

Jay Leftwich, D.D.S.

  • Dentist
  • Seattle, WA
National Provider Identifier
1235459496
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
25397 Issued in TX
Practice address
1660 S Columbian Way
Seattle, WA 98108-1532
Phone
(206) 762-1010
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 25397 TX Primary

Addresses

Primary practice location

1660 S Columbian Way
Seattle, WA 98108-1532

Mailing address

6500 E Mockingbird LN
Ste 115
Dallas, TX 75214-2483
Phone (214) 324-0233

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
I20160502002083 TX Order and Referring Only - DentistPractitioner - Dentist 0042519761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1235459496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 E MOCKINGBIRD LN",
            "address_2": "STE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752142483",
            "telephone_number": "214-324-0233",
            "fax_number": "214-253-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-762-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFTWICH",
        "first_name": "JAY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.