Individual provider Active NPI

Taylor Elizabeth Leeper, DDS

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1346787165
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4694 Issued in NM
Practice address
3410 Indian School Rd NE
Albuquerque, NM 87106-1148
Phone
(505) 265-6921
Fax
(575) 542-8387
NPI assigned
Jan 31, 2017
Last updated
Apr 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD4694 NM Primary

Addresses

Primary practice location

3410 Indian School Rd NE
Albuquerque, NM 87106-1148

Mailing address

3410 Indian School Rd NE
Albuquerque, NM 87106-1148
Phone (505) 265-6921

Other names 1

  • Taylor Elizabeth Krebsbach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20170714000125 NM Practitioner - Dentist 3476823089 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD4694NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hidalgo Medical Services Current Accepting new patients
Hidalgo Medical Services CurrentSince Jul 21, 2017 Accepting new patients
Hidalgo Medical Services CurrentSince Jul 21, 2017 Accepting new patients

Locations

530 De Moss St
Lordsburg, NM 88045
Phone (575) 542-2369

1007 N Pope St
Silver City, NM 88061
Phone (575) 388-1511

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1346787165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 INDIAN SCHOOL RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871061148",
            "telephone_number": "505-265-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 INDIAN SCHOOL RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871061148",
            "telephone_number": "505-265-6921",
            "fax_number": "575-542-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEPER",
        "first_name": "TAYLOR",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "KREBSBACH",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.