Active NPI
Leonid A Portugeys, DDS
- Dentist
- Elmwood Park, NJ
National Provider Identifier
1275707259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI0211051
- Practice address
- 1 Broadway
4C
Elmwood Park, NJ 07407-1842 - Phone
- (201) 791-7700
- NPI assigned
- Apr 21, 2008
- Last updated
- Apr 21, 2008
- 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 | 22DI0211051 | NJ | Primary |
Addresses
Primary practice location
1 Broadway
4C
Elmwood Park, NJ 07407-1842
Mailing address
1577 E 17TH St
2B
Brooklyn, NY 11230-6748
Phone (718) 336-2873
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI0211051 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208736000000",
"number": "1275707259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1577 E 17TH ST",
"address_2": "2B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112306748",
"telephone_number": "718-336-2873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BROADWAY",
"address_2": "4C",
"city": "ELMWOOD PARK",
"state": "NJ",
"postal_code": "074071842",
"telephone_number": "201-791-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTUGEYS",
"first_name": "LEONID",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-21",
"last_updated": "2008-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI0211051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmwood Park, NJ
- Hadley H Phillips, DO
- Howard James Phillips, PT, PHD OCS, FAAOMPT
- Pinnacle MRI Group, LLC
- Elena Marci Podell, LCSW
- Bryant Ramon Ponce
- Jeffrey Paul Powell, DDS
- Precision Pain Management Center PC
- Preferred Home Health Care & Nursing Services, Inc. (Care Options for Kids)
- Preferred Home Healthcare & Nursing Services, Inc.
- David L Principe, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.