Priscilla M Leary, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36824 Issued in TX

Practice address

5721 4TH St NW
Albuquerque, NM 87107-5302

Phone

(505) 345-0515

NPI assigned

Mar 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mekhael Dental PLLC

  • General Practice Dentistry
  • New Braunfels, TX
  • NPI 1891686911
  NPD
• Perfect Teeth - Fourth Street P.C.

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1336260769
  NPD (past)

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1346875978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 TOWN CENTER DR STE 120",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302135",
            "telephone_number": "830-730-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 4TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871075302",
            "telephone_number": "505-345-0515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1University Of New Mexico Msc11 6093",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "210-364-7944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2830 Town Center Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781302135",
            "country_code": "US",
            "telephone_number": "830-730-4072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEARY",
        "first_name": "PRISCILLA",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD5511",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36824",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "TD-00-121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346875978",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346875978",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.aspendental.com/dentist/tx/new-braunfels/2830-town-center-drive-ste-120",
            "affiliation": "N",
            "endpointDescription": "Web address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Web Info",
            "address_1": "2830 Town Center Dr Ste 120",
            "city": "New Braunfels",
            "state": "TX",
            "country_code": "US",
            "postal_code": "781302135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maggie Leahy, ATC, LAT
• Joshua Leak
• Marcella Sisilia Leakehe Farley
• Alexia Leal, PHARMD
• Rita Ann Leard, MD
• Candace Poppas Leas, CNP
• Kirsten Leya Leatherwood
• Leavitt Enterprises
• Leeann Elizabeth Leazier
• Hernan Lebensohn, MD

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.

Verify at the official NPI Registry.