Active NPI
Daniel Young Ho Leigh, DMD
- Periodontics
- Falls Church, VA
National Provider Identifier
1336716877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 0401418806
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 18406 | MD | |
| Periodontics | 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, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220405002759 | MA | Order and Referring Only - Dentist | 5799171476 | |
| I20251119001230 | TX | Order and Referring Only - Dentist | 5799171476 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18406 | MD | MD | Periodontist |
| 0401418806 | VA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Dreams, LLC | Dentist | Past | Accepting new patients |
| Falls Church Modern Dentistry, PC | Dentist | Past | 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.
-
- Dentist
- Falls Church, VA
- NPI 1548728801
-
- Dentist
- Roxbury, MA
- NPI 1225207517
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.