Ronald L Lebroke, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5606 Issued in NV

Practice address

4720 Blue Diamond Rd
#100
Las Vegas, NV 89139-7661

Phone

(702) 855-0050

Fax

(702) 629-2410

NPI assigned

Mar 18, 2008

Last updated

Jun 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1336310309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 S TONOPAH DR",
            "address_2": "SUITE #200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064043",
            "telephone_number": "702-291-2031",
            "fax_number": "702-366-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 BLUE DIAMOND RD",
            "address_2": "#100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397661",
            "telephone_number": "702-855-0050",
            "fax_number": "702-629-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBROKE",
        "first_name": "RONALD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5606",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57069",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336310309",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lekisha Marie Leblanc, MA
• Mayra Lebow, LMT
• Robin Lebowitz
• Anahit Leboyan
• Ydalis Lebrijio
• Dolores Lebron-Gallagher, PA-C
• Marina Lebrun
• Brianna Lebsock
• Emalee Lecates, CF-SLP
• Hallie Lecates

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.