Individual provider Active NPI

Leonard A Merlo, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Rockville, MD
National Provider Identifier
1346245198
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11822 Issued in MD
Practice address
4701 Randolph Rd
Ste G10
Rockville, MD 20852-2259
Phone
(301) 468-0020
Fax
(301) 468-2304
NPI assigned
Jun 17, 2005
Last updated
Apr 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 11822 MD Primary

Addresses

Primary practice location

4701 Randolph Rd
Ste G10
Rockville, MD 20852-2259

Mailing address

4701 Randolph Rd
Ste G10
Rockville, MD 20852-2259
Phone (301) 468-0020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000068 DC Practitioner - Maxillofacial Surgery 7012969280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Temple University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4701 Randolph Rd
Rockville, MD 20852-2259
Phone (301) 468-0020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11822MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Oral & Facial Surgery, LLC Oral and Maxillofacial Surgery Current Accepting new patients
Montgomery Oral & Facial Surgery, LLC Oral and Maxillofacial Surgery CurrentSince Jan 10, 2012 Accepting new patients
Washington Oral & Facial Surgery, PC Current Accepting new patients
Montgomery Oral & Facial Surgery PastSince Jan 1, 1990 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1234 19th St NW
Ste 508
Washington, DC 20036
Phone (202) 223-3391

4701 Randolph Rd
Ste G10
Rockville, MD 20852
Phone (301) 468-0020

Organizations & group practices 5

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1346245198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD",
            "address_2": "STE G10",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522259",
            "telephone_number": "301-468-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD",
            "address_2": "STE G10",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522259",
            "telephone_number": "301-468-0020",
            "fax_number": "301-468-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERLO",
        "first_name": "LEONARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "11822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.