Individual provider Active NPI

David Myer Leader, DMD

  • General Practice Dentistry
  • Malden, MA
National Provider Identifier
1386679140
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16270 Issued in MA
Practice address
389 Main St
Unit 403
Malden, MA 02148-5017
Phone
(781) 397-9229
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16270 MA Primary

Addresses

Primary practice location

389 Main St
Unit 403
Malden, MA 02148-5017

Mailing address

389 Main St
Unit 403
Malden, MA 02148-5017
Phone (781) 397-9229

Other identifiers 1

IdentifierTypeStateIssuer
0208400MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150406000239 MA Order and Referring Only - DentistPractitioner - Dentist 4284952102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16270MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
D2 Dental Associates LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dleader50014@direct.ctc.masshiway.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386679140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 MAIN ST",
            "address_2": "UNIT 403",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485017",
            "telephone_number": "781-397-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 MAIN ST",
            "address_2": "UNIT 403",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485017",
            "telephone_number": "781-397-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "DAVID",
        "middle_name": "MYER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0208400",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.