Jose Rafael De Leon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046096 Issued in NY

Practice address

143 Essex St
New York, NY 10002-2336

Phone

(212) 228-2999

Fax

(212) 228-3323

NPI assigned

Oct 28, 2005

Last updated

Feb 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

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.

• Deleon Dental Office

  • General Practice Dentistry
  • Valley Stream, NY
  • NPI 1316343346
  NPD (past) Authorized official
• Essex Dental Office

  • General Practice Dentistry
  • New York, NY
  • NPI 1477762375
  NPD (past) Authorized official

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1396735411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E CARPENTER ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804404",
            "telephone_number": "516-561-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 ESSEX ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022336",
            "telephone_number": "212-228-2999",
            "fax_number": "212-228-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "JOSE",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01588090",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth De Leon
• Evangeline De Leon
• George De Leon, PHD
• Inna Carmela Mataac De Leon, MD
• Jenniffer De Leon, PA-C
• Michael De Leon
• Miriam G De Leon
• Paola De Leon
• Rachel De Leon, LMSW
• Rose Anne T. De Leon, PT

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.