Active NPI
Christopher John Leja, DMD
- Periodontics
- Grand Rapids, MI
National Provider Identifier
1316266000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2901020877
- Practice address
- 4880 Cascade Rd SE Suite B
Grand Rapids, MI 49546 - Phone
- (616) 940-2854
- NPI assigned
- May 20, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2901020877 | MI | Primary |
Addresses
Primary practice location
4880 Cascade Rd SE Suite B
Grand Rapids, MI 49546
Mailing address
6469 Old Darby Trail NE
Ada, MI 49301
Phone (734) 678-1503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 6, 2026 through May 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020877 | MI | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526601600000",
"number": "1316266000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6469 OLD DARBY TRAIL NE",
"city": "ADA",
"state": "MI",
"postal_code": "49301",
"telephone_number": "734-678-1503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4880 CASCADE RD SE SUITE B",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49546",
"telephone_number": "616-940-2854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEJA",
"first_name": "CHRISTOPHER",
"middle_name": "JOHN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-20",
"last_updated": "2018-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MI",
"license": "2901020877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.