Individual provider Active NPI

Neena Leverenz, DDS

  • Dentist
  • Southfield, MI
National Provider Identifier
1336582162
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020819 Issued in MI
Practice address
25865 W 12 Mile Rd # D1
Southfield, MI 48034-1817
Phone
(248) 535-4010
Fax
(248) 353-0829
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 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 2901020819 MI Primary

Addresses

Primary practice location

25865 W 12 Mile Rd # D1
Southfield, MI 48034-1817

Mailing address

25865 W 12 Mile Rd # D1
Southfield, MI 48034-1817
Phone (248) 535-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150827002385 MI Practitioner - Oral Surgery 7416263041 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gantz DDS PLLC Dentist CurrentSince Apr 5, 2016 Accepting new patients
Shamoun Dental PLLC CurrentSince Sep 8, 2024 Accepting new patients
Gantz, D.D.S., P.L.L.C. Dentist PastSince Apr 5, 2016 Accepting new patients

Locations

25865 W 12 Mile Rd
Ste D112
Southfield, MI 48034
Phone (248) 353-4010

25865 W 12 Mile Rd
Ste D116
Southfield, MI 48034
Phone (248) 353-4010

25865 W 12 Mile Rd
#D1
Southfield, MI 48034
Phone (248) 535-4010

4005 Highland Rd
Waterford, MI 48328
Phone (248) 682-4971

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1336582162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD # D1",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-535-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD # D1",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-535-4010",
            "fax_number": "248-353-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERENZ",
        "first_name": "NEENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.