Marc Ernest Leblanc, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36169 Issued in CA

Practice address

44853 Portola Ave
Suite B
Palm Desert, CA 92260-3703

Phone

(760) 346-1414

Fax

(760) 346-7335

NPI assigned

Oct 11, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Portola Dental Group

  • Preferred Provider Organization
  • Palm Desert, CA
  • NPI 1396175071
  NPD (past) Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1396834362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44853 PORTOLA AVE",
            "address_2": "SUITE B",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603703",
            "telephone_number": "760-346-1414",
            "fax_number": "760-346-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44853 PORTOLA AVE",
            "address_2": "SUITE B",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603703",
            "telephone_number": "760-346-1414",
            "fax_number": "760-346-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "MARC",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "200418543",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Le, DDS
• Stephanie Leard
• Leary and Jesser, Inc.
• Jillian Lebard, DDS
• Jack Lebby, O.D.
• Jose Ramon Ledezma, CPOA CFO
• Heather Lee
• Jason M Lee
• Jonathan Lee
• McKenzie Marie Lee

• General Practice Dentistry in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.