Individual provider Active NPI

Leon Arthur Cerniway, D.M.D.

  • General Practice Dentistry
  • Chesapeake, VA
National Provider Identifier
1376631648
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401006590 Issued in VA
Practice address
680 Kingsborough Square
Suite a
Chesapeake, VA 23320-4988
Phone
(757) 547-9339
Fax
(757) 547-3433
NPI assigned
Oct 11, 2006
Last updated
Dec 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401006590 VA Primary

Addresses

Primary practice location

680 Kingsborough Square
Suite a
Chesapeake, VA 23320-4988

Mailing address

680 Kingsborough Square
Suite a
Chesapeake, VA 23320-4988
Phone (757) 547-9339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 16, 2021 through Mar 16, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401006590VAMDGeneral Practice Dentistry

Organizations & group practices 1

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1376631648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 KINGSBOROUGH SQUARE",
            "address_2": "SUITE A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204988",
            "telephone_number": "757-547-9339",
            "fax_number": "757-547-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 KINGSBOROUGH SQUARE",
            "address_2": "SUITE A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204988",
            "telephone_number": "757-547-9339",
            "fax_number": "757-547-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERNIWAY",
        "first_name": "LEON",
        "middle_name": "ARTHUR",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.