Individual provider Active NPI

Daniel Young Ho Leigh, DMD

  • Periodontics
  • Falls Church, VA
National Provider Identifier
1336716877
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401418806 Issued in VA
Practice address
1212 W Broad St
Falls Church, VA 22046-2116
Phone
(703) 519-6697
NPI assigned
Jun 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 18406 MD
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 0401418806 VA Primary

Addresses

Primary practice location

1212 W Broad St
Falls Church, VA 22046-2116

Mailing address

6243 Summer Pond Dr Apt F
Centreville, VA 20121-4634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220405002759 MA Order and Referring Only - DentistPractitioner - Dentist 5799171476
I20251119001230 TX Order and Referring Only - DentistPractitioner - Dentist 5799171476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18406MDMDPeriodontist
0401418806VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Dreams, LLC Dentist PastSince Aug 1, 2021 Accepting new patients
Falls Church Modern Dentistry, PC Dentist PastSince Jul 7, 2024 Accepting new patients

Organizations & group practices 2

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1336716877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6243 SUMMER POND DR APT F",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201214634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W BROAD ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220462116",
            "telephone_number": "703-519-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIGH",
        "first_name": "DANIEL",
        "middle_name": "YOUNG HO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "18406",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401418806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.