Individual provider Active NPI

Waleska I Velez-Leon, DMD

  • Dentist
  • Winter Garden, FL
National Provider Identifier
1316040819
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN0013300 Issued in FL
Practice address
13275 W Colonial Dr
Winter Garden, FL 34787-3984
Phone
(407) 905-8827
Fax
(407) 654-4528
NPI assigned
Sep 7, 2006
Last updated
Mar 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN0013300 FL Primary

Addresses

Primary practice location

13275 W Colonial Dr
Winter Garden, FL 34787-3984

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other identifiers 1

IdentifierTypeStateIssuer
004764200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160622001683 FL Order and Referring Only - DentistPractitioner - Dentist 8022309020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0013300FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers, Inc Past Accepting new patients
Community Health Centers, Inc. Past Accepting new patients
Community Health Centers, Inc. Past Accepting new patients
Community Health Centers, Inc. Past Accepting new patients

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: waleska.velezleon@chcfl.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1316040819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13275 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873984",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ-LEON",
        "first_name": "WALESKA",
        "middle_name": "I",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0013300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004764200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.